COMPARISON OF LOW-DOSE PREGABALIN VS DULOXETINE IN MANAGING PERIPHERAL NEUROPATHY PAIN IN TYPE 2 DIABETES
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Keywords
Diabetic peripheral neuropathy, pregabalin, duloxetine, pain management, type 2 diabetes, neuropathic pain, quality of life
Abstract
Background: Diabetic peripheral neuropathy (DPN) is a common and debilitating complication of type 2 diabetes, affecting approximately 50% of patients. It is characterized by chronic pain, tingling, and numbness, significantly impacting quality of life. Current treatment options, including anticonvulsants and antidepressants, provide suboptimal pain relief and are often associated with adverse effects. Pregabalin and duloxetine are two widely used agents for managing DPN-related pain, but comparative data on their efficacy and safety remain limited.
Objective: This study aimed to compare the efficacy and safety of low-dose pregabalin and duloxetine in the treatment of peripheral neuropathy pain in patients with type 2 diabetes.
Methods: This was a prospective cohort study conducted at Hayatabad Medical Complex Peshawar, Pakistan from January 1, 2023, to December 31, 2023. A total of 160 patients diagnosed with type 2 diabetes and peripheral neuropathy were randomized into two groups: Group A received pregabalin (75 mg daily), and Group B received duloxetine (30 mg daily). The primary outcome was the change in pain intensity, measured by the Visual Analog Scale (VAS) at baseline, 4 weeks, 8 weeks, and 12 weeks. Secondary outcomes included quality of life, measured using the SF-36 questionnaire, and the incidence of adverse effects. Data were analyzed using independent t-tests, Mann-Whitney U tests, and repeated measures ANOVA.
Results: Both pregabalin and duloxetine significantly reduced pain over the 12-week period (p < 0.001). Group A showed a mean VAS reduction of 4.8 points, while Group B had a reduction of 4.5 points (p = 0.087). Quality of life improved significantly in both groups, with Group A showing a slight advantage in physical health (p = 0.045). Adverse effects were mild, with dizziness and drowsiness more common in Group A and nausea more frequent in Group B.
Conclusion: Low-dose pregabalin and duloxetine are effective in reducing peripheral neuropathy pain in type 2 diabetic patients. While both medications demonstrated similar efficacy in pain reduction, pregabalin was associated with slightly better improvements in physical health. Both treatments were well-tolerated, making them viable options for DPN management.
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Dr Rabail Irfan
Medical Doctor, Hayatabad Medical Complex Peshawar, Pakistan
Dr Talal Safdar
Assistant Professor of Medicine, Fauji Foundation Hospital Rawalpindi, Pakistan
Dr Muhammad Naseer Ud Din
PGR General Medicine, Medical A unit Saidu Group of Teaching Hospital, Saidu Sharif Swat, Pakistan
Dr Ali Nasir
House Officer, Department of Medicine, University College of Medicine and Dentistry, The University of Lahore, Punjab, Pakistan
Dr Asma Ambreen
Associate Professor of Medicine, Fauji Foundation Hospital/Foundation University Medical College
Dr Shahnaz Fatima
Associate Professor Pharmacology Department, Sahara Medical College Narowal, Pakistan