The Nerve Damage of Diabetes
How Is Diabetic Neuropathy Usually Treated?
Treatment aims to relieve discomfort and
prevent further tissue damage. The first step is to bring blood sugar under
control by diet and oral drugs or insulin injections, if needed, and by careful
monitoring of blood sugar levels. Although symptoms can sometimes worsen at
first as blood sugar is brought under control, maintaining lower blood sugar
levels helps reverse the pain or loss of sensation that neuropathy can cause.
Good control of blood sugar may also help prevent or delay the onset of further
Another important part of treatment involves
special care of the feet, which are prone to problems.
A number of medications and other approaches
are used to relieve the symptoms of diabetic neuropathy.
Relief of Pain
For, burning, tingling, or numbness, the
doctor may suggest an analgesic such as aspirin or acetaminophen or
anti-inflammatory drugs containing ibuprofen. Nonsteroidal anti-inflammatory
drugs should be used with caution in people with renal disease. Antidepressant
medications such as amitriptyline (sometimes used with fluphenazine) or nerve
medications such as carbamazepine or phenytoin sodium may be helpful. Codeine
is sometimes prescribed for short-term use to relieve severe pain. In addition,
a topical cream, capsaicin, is now available to help relieve the pain of
The doctor may also prescribe a therapy known
as transcutaneous electronic nerve stimulations (TENS). In this treatment,
small amounts of electricity block pain signals as they pass through a
patient's skin. Other treatments include hypnosis, relaxation training,
biofeedback, and acupuncture. Some people find that walking regularly or using
elastic stockings helps relieve leg pain. Warm (not hot) baths, massage, or an
analgesic ointment such as Ben Gay may also help.
Indigestion, belching, nausea, or vomiting
are symptoms of gastroparesis. For patients with mild symptoms of slow stomach
emptying, doctors suggest eating small, frequent meals and avoiding fats.
Eating less fiber may also relieve symptoms. For patients with severe
gastroparesis, the doctor may prescribe metoclopramide, which speeds digestion
and helps relieve nausea. Other drugs that help regulate digestion or reduce
stomach acid secretion may also be used or erythromycin may be prescribed. In
each case, the potential benefits of these drugs need to be weighed against
their side effects.
To relieve diarrhea or other bowel problems,
antibiotics or clonidine HCl, a drug used to treat high blood pressure, are
sometimes prescribed. The antibiotic tetracycline may be prescribed. A
wheat-free diet may also bring relief since the gluten in flour sometimes
Neurological problems affecting the urinary
tract can result in infections or incontinence. The doctor may prescribe an
antibiotic to clear up an infection and suggest drinking more fluids to prevent
further infections. If incontinence is a problem, patients may be advised to
urinate at regular times (every 3 hours, for example) since they may not be
able to tell when the bladder is full.