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ModerateEndocrinologyDiabetic Peripheral Neuropathyus-abimus-usmle-step-2us-usmle-step-3

A 47-year-old man with long-standing type 2 diabetes presents with progressive numbness and burning pain in both feet. Monofilament testing reveals decreased sensation in a stocking distribution. Glycemic control is suboptimal with HbA1c 9.2 percent. Which medication is recommended as first-line specifically for painful diabetic peripheral neuropathy?

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