Treatment FAQ

what is the treatment for diabetic neuropathy?

by Prof. Haylie Hintz MD Published 3 years ago Updated 2 years ago
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According to guidelines from the American Academy of Neurology , the most effective medications for treating painful diabetic neuropathy (PDN) include: pregabalin (Lyrica) gabapentin (Neurontin) duloxetine (Cymbalta)

How to reduce the risk of diabetic neuropathy?

What test is done to diagnose diabetic neuropathy?

What antidepressants help with nerve pain?

What is the recommended blood sugar level for diabetics?

What is the name of the doctor who treats metabolic disorders?

Does blood sugar management help with diabetes?

Does Tens work for neuropathy?

See more

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What is best treatment for diabetic neuropathy?

According to the American Diabetes Association, patients should consider duloxetine (Cymbalta) as the first treatment. You can also rely on venlafaxine (Effexor XR) but expect side effects such as nausea, sleepiness, dizziness, decreased appetite, and constipation.

What is first line treatment for diabetic neuropathy?

First-line treatment of diabetic peripheral neuropathic pain includes tricyclic antidepressants (e.g., amitriptyline, nortriptyline [Pamelor]). If these agents are contraindicated, newer anticonvulsants (e.g., gabapentin [Neurontin], pregabalin [Lyrica]) should be considered.

Is diabetic neuropathy can be cured?

Diabetic neuropathy has no known cure. The goals of treatment are to: Slow progression.

How do you calm down neuropathy?

Regular exercise, such as walking three times a week, can reduce neuropathy pain, improve muscle strength and help control blood sugar levels. Gentle routines such as yoga and tai chi might also help. Quit smoking.

What is the number one medicine for neuropathy?

The most effective treatment was nortriptyline. Of the study subjects taking this medication, 25% reported their discomfort improved by at least 50%. The least effective treatment was pregabalin: only 15% of study subjects reported that much improvement. Side effects were common with all of the treatments.

How long does it take for diabetic neuropathy to go away?

In one type of diabetic neuropathy—focal neuropathy—the onset of pain is usually sudden and intense. It usually affects on nerve or group of nerves in the head, torso, or legs—but any nerve in the body can be affected. However, focal neuropathy symptoms usually go away in a few weeks.

What triggers diabetic neuropathy?

What causes diabetic neuropathy? Over time, high blood glucose levels, also called blood sugar, and high levels of fats, such as triglycerides, in the blood from diabetes can damage your nerves. High blood glucose levels can also damage the small blood vessels that nourish your nerves with oxygen and nutrients.

Can you reverse diabetic neuropathy in feet?

There is currently no way to reverse diabetic neuropathy, although scientists are working on future treatments. For now, the best approach is to manage blood sugar levels through medication and lifestyle changes. Keeping glucose within target levels can reduce the risk of developing neuropathy and its complications.

What is end stage neuropathy?

Stage 5: Complete Loss of Feeling This is the final stage of neuropathy, and it is where you've lost any and all feeling in your lower legs and feet. You do not feel any pain, just intense numbness. This is because there are no nerves that are able to send signals to your brain.

What is the best treatment for neuropathy in your feet and legs?

An exclusive and effective treatment for neuropathy in the legs and feet, The Combination Electro-analgesia Therapy, (CET), has been extremely effective in relieving pain and discomfort, reversing your numbness, and restoring your sensation while improving your acuity, balance, and strength in your hands and feet.

What's the best home remedy for neuropathy?

8 natural treatments for peripheral neuropathyVitamins. Some cases of peripheral neuropathy are related to vitamin deficiencies. ... Cayenne pepper. Cayenne pepper contains capsaicin, an ingredient in hot peppers that makes them spicy. ... Quit smoking. ... Warm bath. ... Exercise. ... Essential oils. ... Meditation. ... Acupuncture.

What foods should I avoid with neuropathy?

8 Foods That You Should Avoid if You Have Peripheral NeuropathyGluten. ... Alcohol. ... Added Sugars. ... Refined Grains. ... Trans and Saturated Fats. ... Salty Snacks. ... Heavy Metals. ... Produce with Pesticides.

Diabetic Neuropathy: Treatment, Symptoms, Causes

Diabetic neuropathy is a serious but common complication of type 1 and type 2 diabetes that usually develops gradually, over many years. Learn about neuropathy symptoms, treatment, and causes.

Diabetic neuropathy - Symptoms and causes - Mayo Clinic

Diabetic neuropathy is a serious diabetes complication that may affect as many as 50% of people with diabetes. But you can often prevent diabetic neuropathy or slow its progress with consistent blood sugar management and a healthy lifestyle.

List of 27 Diabetic Peripheral Neuropathy Medications Compared - Drugs.com

Rating: For ratings, users were asked how effective they found the medicine while considering positive/adverse effects and ease of use (1 = not effective, 10 = most effective).

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Why is early diagnosis of diabetic neuropathy important?

But since not all foot or limb pain means diabetic neuropathy, accurate diagnosis is important to ensure appropriate treatment.

What causes diabetic neuropathy?

Although the exact causes of diabetic neuropathy are unknown, several factors may contribute to the disorder, including: High blood sugar (glucose). High blood glucose causes chemical changes in nerves and impairs the nerves’ ability to transmit signals. It can also damage blood vessels that carry oxygen and nutrients to the nerves.

What is the name of the neuropathy that affects the internal organs of the heart, digestive system, and sweat

Diabetic Autonomic Neuropathy. Diabetic autonomic neuropathy primarily affects the autonomic nerves that serve internal organs, processes, and systems of the heart, digestive system, sexual organs, urinary tract and sweat glands. This kind of diabetic polyneuropathy can cause symptoms such as:

What is the name of the condition that affects the nerves in the arms, hands, legs and feet?

Diabetic polyneuropathy (DPN) affects multiple peripheral sensory and motor nerves that branch out from the spinal cord into the arms, hands, legs and feet. Typically, the longest nerves — those that extend from the spine to the feet — are affected the most.

Why is aerobic exercise important for neuropathy?

Daily aerobic exercises are shown to protect the nerves and improve neuropathy outcomes . Losing weight is also important if a patient is obese or overweight.

How long does it take for neuropathy to develop?

Significant nerve problems (clinical neuropathy) can develop within the first 10 years after a diabetes diagnosis. The risk of developing neuropathy increases the longer you have diabetes. About half of people with diabetes have some form of neuropathy.

Where does proximal neuropathy start?

The main symptom is nerve pain that starts in the upper thigh of one leg and can involve the hip and lower back. Weight loss is a symptom in about 35% of patients with proximal neuropathy, and about 18% experience weakness in the affected area in addition to the pain. Rarely, proximal neuropathy can occur in the arm.

Overview

Diabetic neuropathy refers to nerve damage caused by high blood sugar due to diabetes.

Symptoms and Causes

Diabetes that is not well-controlled can lead to hyperglycemia (high blood sugar). Over time, elevated blood sugar can damage your nerves. Too much blood sugar can also lead to damage to your blood vessels, which bring oxygen and nutrients to your nerves.

Diagnosis and Tests

Diabetic neuropathy diagnosis usually involves a foot exam. Your healthcare provider checks your feet for sores, blisters or injuries. Your provider may also touch your feet with special instruments to check for decreased sensations.

Management and Treatment

Diabetic neuropathy treatment involves carefully managing your blood sugar. Controlling diabetes is the most important step to prevent nerve damage from getting worse. You can control your blood sugar through:

Living With

People with nerve damage may get depressed or discouraged. Talk with your healthcare provider about your mental health. You may benefit from:

What is the best treatment for DPN?

Major international clinical guidelines for the management of DPN recommend several symptomatic treatments. First-line therapies include tricyclic antidepressants, serotonin-noradrenaline reuptake inhibitors, and anticonvulsants that act on calcium channels.

Is diabetic neuropathy a disabling condition?

Diabetic neuropathy is a highly prevalent, disabling condition, the management of which is associated with significant costs. Evidence supports the use of specific anticonvulsants and antidepressants for pain management in patients with diabetic peripheral neuropathy.

Why do diabetics get neuropathy?

Researchers think that over time, uncontrolled high blood sugar damages nerves and interferes with their ability to send signals, leading to diabetic neuropathy .

How many types of diabetic neuropathy are there?

There are four main types of diabetic neuropathy. You can have one type or more than one type of neuropathy. Your symptoms will depend on the type you have and which nerves are affected. Usually, symptoms develop gradually. You may not notice anything is wrong until considerable nerve damage has occurred.

What are the risks of diabetes?

Poor blood sugar control. Uncontrolled blood sugar puts you at risk of every diabetes complication, including nerve damage. Diabetes history. Your risk of diabetic neuropathy increases the longer you have diabetes, especially if your blood sugar isn't well controlled. Kidney disease.

What causes numbness in the legs and feet?

Diabetic neuropathy most often damages nerves in your legs and feet. Depending on the affected nerves, diabetic neuropathy symptoms can range from pain and numbness in your legs and feet to problems with your digestive system, urinary tract, blood vessels and heart. Some people have mild symptoms.

How does nerve damage affect your body?

Nerve damage can also affect your ability to feel when you need to urinate or to control the muscles that release urine, leading to leakage (incontinence). Sharp drops in blood pressure. Damage to the nerves that control blood flow can affect your body's ability to adjust blood pressure.

What is the autonomic nervous system?

The autonomic nervous system controls your heart, bladder, stomach, intestines, sex organs and eyes. Diabetes can affect nerves in any of these areas, possibly causing: A lack of awareness that blood sugar levels are low (hypoglycemia unawareness) Bladder or bowel problems.

How do you know if you have autonomic neuropathy?

But if you have autonomic neuropathy, you may not notice these warning signs. Loss of a toe, foot or leg. Nerve damage can make you lose feeling in your feet, so even minor cuts can turn into sores or ulcers without your realizing it. In severe cases, an infection can spread to the bone or lead to tissue death.

Ask the experts

I have diabetic neuropathy all over my body (legs, feet, skin is very sensitive to temperature and clothing). Anything touching my skin feels like sandpaper, and temperature changes cause me to have the shakes and severe pain. The pain medication I have been using isn't working. What are treatment options for a patient with diabetic neuropathy?

Doctor's response

There are newer medications on the market that may be of benefit called duloxetine ( Cymbalta) and Lyrica. You should speak with your doctor about the possibility of trying these agents either alone or in combination with other medication.

How to reduce the risk of diabetic neuropathy?

Lifestyle and home remedies. These measures can help you feel better overall and reduce your risk of diabetic neuropathy: Keep your blood pressure under control. If you have high blood pressure and diabetes, you have an even greater risk of complications.

What test is done to diagnose diabetic neuropathy?

Along with the physical exam, your doctor may perform or order specific tests to help diagnose diabetic neuropathy, such as: Filament test. Your doctor will brush a soft nylon fiber (monofilament) over areas of your skin to test your sensitivity to touch. Sensory testing.

What antidepressants help with nerve pain?

Some antidepressants ease nerve pain, even if you aren't depressed. Tricyclic anti depressants may help with mild to moderate nerve pain. Drugs in this class include amitriptyline, desipramine (Norpramin) and imipramine (Tofranil). Side effects can be bothersome and include dry mouth and drowsiness.

What is the recommended blood sugar level for diabetics?

But, in general, the American Diabetes Association recommends the following target blood sugar levels for most people with diabetes: Between 80 and 130 mg/dL, which is 4.4 and 7.2 millimoles per liter (mmol/L) before meals.

What is the name of the doctor who treats metabolic disorders?

An endocrinologist is a doctor who specializes in treating metabolic disorders, such as diabetes. You may also be referred to a neurologist, which is a doctor who specializes in treating nervous system problems. To prepare for your appointment, you may want to: Be aware of any pre-appointment restrictions.

Does blood sugar management help with diabetes?

Good blood sugar management may even improve some of your current symptoms. Your doctor will figure out the best target range for you based on factors including your age, how long you've had diabetes and your overall health. Blood sugar levels may need to be individualized.

Does Tens work for neuropathy?

Although safe and painless, TENS doesn't work for everyone or for all types of pain. Acupuncture. Acupuncture may help relieve the pain of neuropathy, and generally doesn't have any side effects.

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Overview

  • Diabetic neuropathy is a type of nerve damage that can occur if you have diabetes. High blood sugar (glucose) can injure nerves throughout your body. Diabetic neuropathy most often damages nerves in your legs and feet.Depending on the affected nerves, symptoms of diabetic neuropathy can range from pain and numbness in your legs and feet to problems with your digestive system…
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  • DPN is damage to the nerves in your arms, hands, legs, and feet. DPN is most common in the legs and feet and can increase your risk for foot ulcers. Nerve pain caused by DPN can limit your mobility, and affect your quality of life.
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Treatment

  • Your healthcare provider will check your reflexes, strength, and flexibility. A 10-g monofilament test will be done. A monofilament is a device with one flexible strand that will touch the soles of your feet. Your healthcare provider may also do a pinprick, temperature, or vibration sensation test. Controlled blood sugar levels is the only treatment for DPN. Controlled blood sugar levels c…
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  • The first treatment step is to bring blood glucose levels within the normal range to help prevent further nerve damage. Blood glucose monitoring, meal planning, physical activity, and diabetes medicines or insulin will help control blood glucose levels. Symptoms may get worse when blood glucose is first brought under control, but over time, maintaining lower blood glucose levels help…
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Prevention

  • You can prevent or delay diabetic neuropathy and its complications by keeping tight control of your blood sugar and taking good care of your feet.
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  • Keep your blood sugar levels as close to normal as possible by taking your medicines as directed. Check your blood sugar levels as often as directed. Contact your healthcare provider if your levels are higher than they should be.
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  • 1. Tight glycaemic control has been clearly shown to reduce the risk of neuropathy. 2. Smoking avoidance or cessation.
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Causes

  • The exact cause likely differs for each type of neuropathy. Researchers think that over time, uncontrolled high blood sugar damages nerves and interferes with their ability to send signals, leading to diabetic neuropathy. High blood sugar also weakens the walls of the small blood vessels (capillaries) that supply the nerves with oxygen and nutrients.However, a combination o…
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  • In diabetic peripheral neuropathy, chronically high blood sugar levels as a result of diabetes damage nerves not only in the extremities, but throughout the body. This impairs nerve signaling between the brain, and vital organs and tissues of the body. Three groups of nerves are affected by diabetic peripheral neuropathy:
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Diagnosis

  • Laboratory tests that may be helpful include the following: 1. Fasting plasma glucose 2. Hemoglobin A1c 3. Complete blood count 4. Complete metabolic panel (electrolytes and liver function panel) 5. Vitamin B-12 and folate levels 6. Thyroid function tests 7. Erythrocyte sedimentation rate 8. C-reactive protein 9. Serum protein electrophoresis with immunofixation el…
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  • Peripheral neuropathy is diagnosed based on objective signs, symptoms, and a physical exam that includes a check of blood pressure, heart rate, muscle strength, reflexes, and sensitivity to position changes, vibration, temperature, or light touch.
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Management

  • Key components of the management of diabetic neuropathy include the following: 1. Foot care, including regular follow-up, patient education, and referral as appropriate 2. Tight, stable glycemic control (most important for slowing progression of neuropathy) 3. Pain management (eg, with pregabalin, gabapentin, sodium valproate, dextromethorphan, morphine sulfate, tramadol, oxyco…
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  • 1. Regular surveillance for signs of neuropathy to allow early intervention. 2. Tight glycaemic control. 3. Prevention of foot trauma.
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Symptoms

  • There are four main types of diabetic neuropathy. You can have one or more than one type of neuropathy. Your symptoms will depend on the type you have and which nerves are affected. Usually, symptoms develop gradually. You may not notice anything wrong until considerable nerve damage has occurred.
See more on mayoclinic.org

Epidemiology

  • Neuropathies related to diabetes can affect 60-70% of people with diabetes. Neuropathy associated with type 2 diabetes may be present at the time of diagnosing diabetes. Neuropathy associated with type 1 diabetes usually develops more than 10 years after the diagnosis of diabetes. Diabetes is the most common cause of peripheral neuropathy in the world.
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Prognosis

  • 1. Autonomic neuropathy is associated with a high mortality rate, mainly due to its association with chronic kidney disease, cardiopathy and hypotension. 2. Diabetic peripheral neuropathy is a major cause of morbidity and increased mortality and increases the risk of burns, injuries and foot ulceration. 3. People with diabetes are more likely to undergo lower limb amputation.
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Diagnosis

  • A doctor can usually diagnose diabetic neuropathy by performing a physical exam and carefully reviewing your symptoms and medical history. Your doctor will check your: 1. Overall muscle strength and tone 2. Tendon reflexes 3. Sensitivity to touch and vibration Along with the physica…
See more on mayoclinic.org

Treatment

  • Diabetic neuropathy has no known cure. The goals of treatment are to: 1. Slow progression of the disease 2. Relieve pain 3. Manage complications and restore function
See more on mayoclinic.org

Lifestyle and Home Remedies

  • These measures can help you feel better overall and reduce your risk of diabetic neuropathy: 1. Keep your blood pressure under control.If you have high blood pressure and diabetes, you have an even greater risk of complications. Try to keep your blood pressure in the range your doctor recommends, and be sure to have it checked at every office visit. 2. Make healthy food choices.…
See more on mayoclinic.org

Coping and Support

  • Living with diabetic neuropathy can be difficult and frustrating. If you find yourself feeling depressed, it may help to talk to a counselor or therapist. Support groups also can offer encouragement and advice about living with diabetic neuropathy. Ask your doctor if there are any in your area, or for a referral to a therapist. The American Diabetes Association offers online sup…
See more on mayoclinic.org

Preparing For Your Appointment

  • If you don't already see an endocrinologist, you'll likely be referred to one if you start showing signs of diabetes complications. An endocrinologist is a doctor who specializes in treating metabolic disorders, such as diabetes. You may also be referred to a neurologist, which is a doctor who specializes in treating nervous system problems. To prepare for your appointment, y…
See more on mayoclinic.org

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