Diabetic Neuropathy Treatment

Diabetes brings on a host of issues including the nerve pain called diabetic neuropathy. If you are suffering from diabetic neuropathy treatment is important.

Some symptoms og diabetic neuropathy are obvious: pain in your feet. But more subtle signs of neuropathy are just as critical to notice and get treatment for.

“We ask whether people are having unusual tingling or numbness,” says Dace L. Trence, MD, an endocrinologist and director of the Diabetes Care Center at the University of Washington Medical Center in Seattle. Those symptoms are signs of possible nerve damage, and are just as important as nerve pain.
Nerve pain and damage in your hands or feet is called peripheral neuropathy.

Continued glucose control can help reduce the possible risk of complications such as diabetic neuropathy, says the American Diabetes Association (ADA). Nerve damage caused by diabetes generally occurs over years and is due to a prolonged high blood sugars, as well as other factors. If you are doing what you can to control your diabetes, it will help to control your neuropathy and protect your nerves, as well.

There are three main things that you can do to keep your diabetic neuropathy and diabetes under control:

Get – and keep – Your Blood Sugar Under Control
The experts all agree: the first step in treating diabetic nerve pain is to bring your glucose levels under control.

The best ways to do this are to use your glucose meter throughout the day. “We suggest that people get a better picture of what’s happening to their blood sugar levels throughout the day,” says Trence. “Sometimes that can be helpful, particularly if the person hasn’t been checking that frequently.”

In addition, Meet your target.
While individual blood glucose goals may vary, the National Diabetes Information Clearinghouse (NDIC) gives these general guidelines:
before meals: 90 – 130 mg/dL
1 to 2 hours after starting a meal: less than 180 mg/dL
Your doctor may have advised different numbers for you, based on your symptoms of nerve pain and other diabetes complications. Always follow your doctor’s specific advice on the glucose goal that’s right for you.

Make sure to Eat right.
A diet that helps treat nerve pain is really no different than a good, healthy, balanced diet, says Trence. “The emphasis is really on blood sugar control,” she says. A good diet outlines what to eat, when to eat, how much to eat, and allows for healthy snacks.

Be active and exercise.
Try to be active for 30 minutes on most days. Exercise helps to lower your blood sugar, so it’s a way to help manage diabetes complications like nerve pain – and help keep your blood pressure and blood fats under control. Talk to your doctor about what is right for you.

Take the A1c test.
In addition to your glucose meter, this test shows whether you’re controlling your blood sugar over time. The A1c test is a simple blood test that measures the average amount of glucose in your blood for the previous 2 to 3 months, and the NDIC recommends taking it at least twice a year. But you can do it more often. “Most of us are really believing it should be done every 3 to 4 months,” says Trence. “It’s such a powerful piece of information to have, to complement a patient’s own blood sugars.”

Strict blood sugar control means an average level of A1c of less than 7%. If your test results are higher than 8%, you should talk to your doctor about any necessary changes in how you’re managing your diabetes. An A1c higher than 7% means that you have a greater chance of eye disease, kidney disease, and nerve damage.

Consider your diabetes medications.
“Sometimes, the blood sugar just has not achieved the target that is ideal,” says Trence, “so we switch therapies to get better control.” A side benefit may be relief from nerve pain. In a recent study in Diabetes Care, published by the ADA, people who used insulin injections for strict glucose control were less likely to get neuropathy. And those on an intensive regimen of taking insulin 3 or more times a day lowered their chances of tingling, burning, and other symptoms of neuropathy by 64% – a significant benefitn
Make sure to treat your nerve pain. There are many options to soothe diabetic nerve pain, depending on your symptoms and their severity.

Talk to your doctor about self care.
Warm baths and frequent walks, for some people, can relieve mild symptoms of peripheral nerve pain. Ask your doctor if baths and walks are safe for you, since they could interfere with healing if you have cuts or sores in your feet. Wear shoes that fit well and allow your toes to move.

Ask about pain medications.
Pain can be a difficult symptom to control, so it may take time to find the right treatment for you. Cymbalta and Lyrica are the only FDA-approved medications for the treatment of painful diabetic neuropathy; however, your doctor might suggest other treatments thar can be effective for pain control including
Prescription-strength nonsteroidal anti-inflammatory drugs (NSAIDs), Narcotics, Antidepressants such as Amitril, Norpramin or Tofranil.Antiseizure medications such as Dilantin, Tegretol, Neurontin or Lamictal
or other medications block or reduce the release of chemicals that cause pain to be transmitted.

You can also try other therapies. Acupuncture works to treat nerve pain for some people, says Trence, as does anodyne therapy, a treatment that uses infrared light to soothe pain, usually done in a physical therapy office.

“[Vitamin] B-12 actually can work,” says Trence. “The problem is that if you take too much of it, it can cause its own neuropathies.”

Surgical decompression of multiple peripheral nerves (called the Dellon procedure) is an alternative method for treating diabetic neuropathy.

Once your nerve pain is under control, there are things you can do to try to delay further damage to your nerves. Keep close daily control of your glucose, and avoid big swings in blood sugar. Keep exercising regularly and eating right. Lose weight if you need to, since excess weight puts more pressure on painful feet. Take special care of your feet -which is essential since nerve damage is so common in the feet.

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