If your PN is the result of diabetes, then tight glucose control is obviously the first step. There's also other drugs available - lyrica, etc. that may help. (But, you probably know that already if your in the healthcare field.)

There's a lot of supplements that can help - particularly with diabetic PN. Have you tried any of these?? Alpha lipoic acid, bentotiamine, B12 (methylcobalamin), methylfolate, acetyl-l-carnitine, CoQ10, fish oil, curcumin, the list goes on...

Check out the supplements and B12 threads. And ask questions here. There's lots of people who can provide advice regarding how to cope.