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Diabetic Neuropathies

Prevention & Treatment

Monday, Aug. 27, 2007; 7:44 PM

Copyright Harvard Health Publications 2007

Prevention

Table of Contents

Because diabetic neuropathy is caused by abnormally high levels of blood glucose, diabetics can help to prevent this problem by regulating their blood sugar levels intensely. In a 10-year study conducted by the National Institute of Diabetes and Digestive and Kidney Disease (NIDDK), diabetics who kept their blood glucose levels close to normal reduced their risk of peripheral neuropathy by 60%. Avoiding smoking can help to prevent or delay neuropathies, one of several important reasons that people with diabetes should not smoke.

Treatment

Treatment of diabetic neuropathy focuses on:

  • Tighter control of blood glucose

  • Pain relief

  • A regular exercise program to burn glucose and build muscle strength

  • Avoiding smoking

  • Medications to treat autonomic problems and prevent bladder infections

  • Physical therapy

  • Meticulous care of the feet

To relieve the pain of peripheral neuropathy, your doctor may prescribe a medicine. A growing number of medicines are available to reduce nerve pain, including low doses of tricyclic medications, such as amitriptyline (Elavil), nortriptyline (Aventyl, Pamelor) and desipramine (Norpramin and other brand names). Other medicines that may help include gabapentin (Neurontin), duloxetine (Cymbalta) and carbamazepine (Tegretol). For persisting pain, your doctor may suggest that you take aspirin, acetaminophen (Tylenol) or ibuprofen (Advil, Motrin and other brand names) by mouth or that you rub on a pain-relieving cream containing capsaicin. In more severe cases, doctors may prescribe narcotic medicines.

To treat mild digestive problems caused by slow stomach emptying, your doctor may suggest that you eat small, frequent meals that are low in fat and fiber. For more severe symptoms, your doctor may prescribe the medication metoclopramide (Reglan and other brand names) to help digestion. Occasionally, the antibiotic erythromycin (sold under several brand names) is helpful, because it has a side effect of increasing the movement of the stomach and small intestine.

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