With increasing obesity among young people, the prevalence of type 2 diabetes mellitus (DM) is growing worldwide with diagnosis occurring at an earlier age . In the United States, American Indians and Alaska Natives (AIAN) are at greater risk for DM diagnosis  and suffer disproportionately higher rates of diabetic amputation than the general United States (US) population .
Overall, one third of adults with DM are estimated to suffer with diabetic peripheral neuropathy (DPN) symptoms. Pain management is challenging, with multiple medications typically prescribed for those with greater severity of symptoms . Symptomatic treatment generally includes prescription and/or over-the-counter pain medications; specifically, nonsteroidal anti-inflammatory drugs (NSAIDS), opioids, anticonvulsants, selective serotonin reuptake inhibitors/selective norepinephrine reuptake inhibitors, and tricyclic antidepressants .