Treatment of Diabetic Neuropathy

If you have diabetes (especially if diabetes is not controlled well), high blood sugar level can damage nerves in any part of the body causing diabetic neuropathy. However, diabetic neuropathy usually damages nerves of legs and feet. Depending on the extent of nerve damage, the symptoms of diabetic neuropathy may vary from mild pain and numbness in legs and feet to serious problems such as problem with digestive system, urinary system, cardiovascular system as well as heart problems. The best way to prevent diabetic neuropathy as well as any complications due to diabetes is to control blood sugar level optimally.id-10038463

Treatment of diabetic neuropathy:

The problems due to diabetic neuropathy cannot be removed. The management focuses on slowing progression of diabetic neuropathy, pain relief and management of complications due to diabetic neuropathy.

Slowing down the progression of diabetic neuropathy:

The best way to slow down the progression of diabetic neuropathy, is of course to control blood sugar level 24 hours a day. Sometimes symptoms may even improve, especially if damage is minimal. Your doctor will determine the blood sugar level you need to manage. For example if you are 59 years or younger, and without any other serious medical condition, your doctor may set a target range of 80 mg/dl to 120 mg/dl. If you are 60 years or older and have some underlying medical condition (heart problem, kidney problem etc.), your doctor may set a target range of 100 mg/dl to 140 mg/dl. Your doctor will also ask you to follow certain recommendations to slow nerve damage, such as

  • Quit smoking
  • Follow healthy eating plan
  • Avoid excess alcohol
  • Take care of your feet well
  • Keep blood pressure and body weight under control
  • Do regular physical exercise

Pain relief in diabetic neuropathy:

There are several medications available for pain relief. However, all medications do not work for every patient and need to be carefully used (as they may cause side effects, which may be worse than pain itself). Commonly used pain medications in diabetic neuropathy, include,

  • Anti-seizure medications (being neuropathic pain, commonly used pain medications such as nsaids do not work) such as gabapentin, pregabalin, carbamazepine etc.
  • Antidepressants: tricyclic antidepressants such as amitriptylin, imipramine etc. Are also used in pain of diabetic neuropathy. These medications also have side effects and need to be carefully evaluated.

Managing complications due to diabetic neuropathy:

These depend on the problem/complication.

  • Urinary tract problem: depending on the problem, your doctor may prescribe anti-spasmodic medication, use devices (such as ring pessary inserted in vagina to prevent leakage), behavioral therapy etc. These may be used in combination too.
  • Digestive problems such as gastroparesis may be relieved by eating small and frequent meals, low fat meal and other dietary modifications. Some medications may also help relieve symptoms.
  • Low blood pressure, especially orthostatic hypotension (low bp on standing) can be relieved by using simple techniques such as sitting of standing slowly, drinking lots of water and some medications.
  • Sexual dysfunctions may be relieved by using various medications such as sildenafil, tadalafil etc.

 

Image courtesy of [Ambro] at FreeDigitalPhotos.net

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