<prompt> First line drug used for painful diabetic neuropathy is ?CarbamazepineDuloxetineVenlafaxineEMLA  <response>: Chronic, painful diabetic neuropathy is difficult to treat but may respond to duloxetine, amitriptyline, gabapentin, valproate, pre- gabalin, or opioids. Two agents, duloxetine and pregabalin, have been approved by the U.S. Food and Drug Administration FDA for pain associated with diabetic neuropathy, but no treatments are satisfactory. Reference : page 2427 Harrisons Principles of Internal Medicine 19th edition 