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MediumEndocrinologyPainful Diabetic Neuropathyukmlamrcgp aktpanemrcp part 1prescribing safety assessment

A 55-year-old woman presents with bilateral burning pain and numbness in her feet, worse at night. She has a history of type 2 diabetes for 10 years, managed with metformin and gliclazide, with recent HbA1c of 78 mmol/mol (9.3%). Neurological examination reveals reduced sensation to light touch and pinprick up to the ankles bilaterally, and absent ankle reflexes. According to NICE NG217, what is the recommended first-line pharmacological treatment for painful diabetic neuropathy?

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