Long-standing diabetes can cause severe peripheral neuropathy, and sometimes Gabapentin alone may not provide enough relief. Doctors may consider alternatives or combination treatment such as Pregabalin, Duloxetine, methylcobalamin (vitamin B12), or topical pain-relief treatments depending on your condition and kidney function. Strict blood sugar control is very important because uncontrolled diabetes can worsen nerve damage. Regular walking, physiotherapy, foot care, proper footwear, and avoiding smoking/alcohol may also help reduce burning and stiffness. Since symptoms are persistent despite treatment, please consult a neurologist or diabetologist for reassessment, dose adjustment, and evaluation for complications such as poor circulation or vitamin deficiencies.

Diabetic neuropathy with ongoing pain and swelling, along with high sugar, suggests your diabetes is not well controlled. Better glucose control is key, as high sugar can worsen nerve damage and symptoms. Measures such as leg elevation, gentle activity, and proper foot care may help reduce discomfort. Consult a doctor to adjust your medicines and manage both pain and swelling effectively.

Your blood sugar of 196 mg/dL is high, indicating your diabetes is not well controlled; your doctor may need to adjust your Wosulin or Glycomet doses. The numbness in your feet suggests diabetic neuropathy. This requires strict blood sugar control and medications like Pregabalin, Gabapentin, or Methylcobalamin to manage nerve symptoms. Your Vitamin D level (14.3 ng/mL) is deficient; I recommend weekly Cholecalciferol (60,000 IU) supplements for 8 weeks. Insomnia can be linked to neuropathy pain or high blood sugar. Please consult your physician immediately to safely adjust your prescriptions, evaluate your feet, and address sleep issues.

Managing chronic pain after a D12 spinal cord injury requires a tailored approach, as this pain is often neuropathic (nerve-related). First-line medications typically include gabapentinoids (such as gabapentin or pregabalin) or certain antidepressants (like amitriptyline or duloxetine), which help calm overactive nerves. If muscle spasms contribute to your pain, muscle relaxants like baclofen may be prescribed. For musculoskeletal pain, simple anti-inflammatories can assist. Because these medications require precise dosing, have potential side effects, and must be carefully managed, please consult your neurologist or a pain specialist to develop a safe, personalised prescription plan.