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Objective. To facilitate the clinician's understanding of the basis and treatment of painful diabetic neuropathy (PDN).

Background. PDN is one of several clinical syndromes in patients with diabetic peripheral neuropathy (DPN) and presents a major challenge for optimal management.

Methods. A systematic review of the literature was undertaken for articles specific to PDN, using Medline databases between 1966 and 2007.

Results. The epidemiology of PDN has not been well established and on the basis of available data the prevalence of pain is 10% to 20% in patients with diabetes and from 40% to 50% in those with diabetic neuropathy. It has a significant impact on the quality of life and health care costs. Pathophysiologic mechanisms underlying PDN are similar to other neuropathic pain disorders and are broadly characterized as peripheral and central sensitization …