The use of gabapentin, a first-line drug for diabetic peripheral neuropathy (DPN), is limited by its side effects and is conditional on being prescribed according to the Thai national drug list, leading to more frequent use of vitamin B as an alternative. This randomised controlled trial of 237 patients in Primary care units in Sri Samrong, Sukhothai, between October 2024 and January 2025 whom diagnosed with diabetes and at least probable DPN, assessed pain outcomes using the Revised Thai Short-Form McGill Pain Questionnaire (SFMPQ), Visual Analogue Scale (VAS), Present Pain Intensity (PPI), and monofilament risk score at baseline and 4 and 12 weeks. Gabapentin showed superior improvement across all measures compared with vitamin B1-6-12 and B12, supporting its role as first-line therapy. Gabapentin has lower SFMPQ -6.6(-7.3,-5.9) and PPI -1.3(-1.5,-1.1) compared to Vitamin B12 which has SFMPQ -5.3(-6.1,-4.6) and PPI -0.9(-1.1,-0.8) significantly (p-value=0.003) but does not show any significance compared to vitamin B1-6-12. Namely, vitamin B1-6-12 remains a cost-effective alternative with comparable effectiveness and lower side effects, warranting further economic evaluation.

Nattawat Poolsawatkitikool completed his MD at the age of 24 years from Chiang Mai University, Thailand and completed a Diploma of the Thai Board of Family Medicine at the age of 28 years from Buddhachinaraj Phitsanulok Hospital, Thailand. He is now working as a family physician at Srisangworn Sukhothai Hospital and has a research interest in primary care and diabetic care.