Pregabalin versus Gabapentin in the Management of Painful Diabetic Neuropathy

Diabetic neuropathy develops in the majority of poorly controlled diabetic patients as a late complication. Painful diabetic neuropathy represents a major health problem as it may present with excruciating neuropathic pain and is responsible for substantial morbidity, increased mortality and impaired quality of life. The aim is to compare the efficacy of Pregabalin and Gabapentin in painful diabetic neuropathy. This study was conducted on 100 diagnosed patients of diabetes with painful diabetic neuropathy presenting in the department of Medicine of a tertiary care teaching hospital of Punjab, India. Patients were divided in two groups of 50 each. Pregabalin (150-300 mg/day) was administered to group I and Gabapentin (300-2400 mg/day) to group II for 6 weeks. Follow up assessment of various clinical parameters was done at weekly intervals while Visual Analogue Scale (VAS) Score and Likert Scale Score assessments were done at 2, 4 and 6 weeks of treatment. Overall, it was observed that both Pregabalin and Gabapentin showed an improvement in VAS score and Likert scale score, but the improvement was significantly more with Pregabalin than Gabapentin. In this study, Pregabalin was clearly superior to Gabapentin in the improvement of parameters like spontaneous pain, burning sensation and numbness. This study concluded that it is important to treat patients with painful diabetic neuropathy with tailor-made approach. Monotherapy with Pregabalin or Gabapentin produced clinically meaningful pain relief however; pain reduction was superior with Pregabalin compared to Gabapentin. Therefore, it is suggested that Pregabalin could be a better therapeutic option in patients with painful diabetic neuropathy.