Changes in serotoninergic and noradrenergic descending pain pathways during painful diabetic neuropathy: The preventive action of IGF1

► Painful diabetic neuropathy induces neuronal hyperactivity at spinal cord and PAG. ► Serotonin and noradrenaline levels are increased at spinal cord of STZ-diabetic rats. ► Serotoninergic and noradrenergic brainstem neurons are hyperactivated during diabetes ► IGF1 inhibits spinal cord and PAG neuronal hyperactivation during diabetes. ► IGF1 prevents the monoamine changes in pain control system during diabetes.