糖尿病神經病變是最好發的糖尿病併發症。而糖尿病神經病變併發疼痛症狀則至少佔有三分之一。危險因子包含血糖控制不良，高血壓，身高，年紀，高膽固醇血症有關。糖尿病神經病變分類眾多，大多數皆會引起疼痛，而此疼痛多半影響睡眠，進而引發作息失調，慢性疲勞，肌肉無力，及憂鬱等症狀。本文將探討糖尿病神經病變好發神經痛的機制，及治療。

Background and purpose: The definition, clinical presentation, and treatment of diabetic neuropathic painwere reviewed. Results: The estimated prevalence of diabetic neuropathic pain is up to 22%based on a population of 270million in theUS. Diabetic neuropathy is one of themost common complications of type 2 diabetes mellitus (T2DM). Diabetic neuropathic pain is a sensorimotor neuropathy, or a distal symmetrical polyneuropathy,which is themost common type of excruciating, refractory pain in T2DM patients. Positive symptoms include pain and paresthesia. Patients complain about burning, tingling, aching, cold sensation, lancinating pain, numbness, or pain from normal touch. Painful symptoms occur in a part (11%-32%) of neuropathic patients with diabetes and do not correlate with diminished nerve conduction velocity. Thus electrophysiological testing is rarely needed according to the ecommendations of the American Diabetes Association in 2010. Themultifactorial pathogenesis of diabetic neuropathy suggested by recent research includes the polyol pathway, oxidative stress, advanced glycation nd products, and protein kinase C. Medications for relief of diabetic neuropathic pain are recommended to improve the quality of life. For neuropathic pain control, the efficacy of tricyclic antidepressants, gabapentin, pregabalin, opioids, and tramadol is documented. Selective erotonin noradrenaline reuptake inhibitors, topical lidocaine, and transcutaneous electrical stimulation are therapieswith some evidence of efficacy. Conclusions: Treatment is a great challenge, and has to be individualized to each patient, by taking into account side effects, pain ype, comorbidities, and drug interactions. As poor glycemic control may worsen diabetic neuropathic pain, it is important to achieve a glucose target as rapidly as possible.