29th May 2025

A 68-year-old male with type 2 diabetes mellitus attends clinic for routine follow-up.

A 68-year-old male with type 2 diabetes mellitus attends clinic for routine follow-up. He has had diabetes for 7 years and his most recent HbA1c was 56 mmol/L.  He reports burning pain in his extremities, affecting his daily activities and sleep, which hasn’t responded to treatment with amitriptyline titrated to the maximum dose. What is the most appropriate next step in management? 

Select the SINGLE most appropriate option from the list below. Select ONE option only.