The first step in the treatment of diabetic neuropathy is prevention. Diabetic neuropathy cannot be cured and the damage done to the nerves cannot be repaired, so it is vital that people with diabetes prevent its occurrence.
Prevention includes a consistently following a plan to treat diabetes and normalize blood sugar levels as much as possible to prevent nerve damage. This generally includes medications, regular medical and blood sugar monitoring, and lifestyle and dietary changes.
Meticulous skin care and skin hygiene is critical to preventing infections of the extremities. People with diabetic neuropathy are at risk for serious infections, such as gangrene. When a bacterial infection has developed, antibiotics, regular medical monitoring and special dressings are used to treat it.
Once diabetic neuropathy has developed, treatment plans are individualized depending on the specific type of diabetic neuropathy, severity, symptoms, complications, the presence of coexisting diseases, the age of the patient, and other factors. Treatment generally involves a multifaceted plan that minimizes the pain and abnormal sensations of diabetic neuropathy and the risk of developing complications, such as gangrene and disability.
Treatment may include medications to help minimize pain and other uncomfortable sensations. Alternative or complementary treatments that may be helpful for some symptoms include acupuncture and biofeedback.
Medications may also be prescribed to help control other problems, such as impotence, hypotension, and incomplete bladder emptying.
Treatment may also include physical therapy. The use of walkers and other assistive devices, such as grab rails in the bathroom, may be needed to maintain independence and maximize safety for people with advanced diabetic neuropathy.
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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 problems.
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.
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.
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 causes diarrhea.
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.
Muscle weakness or loss of coordination caused by diabetic neuropathy can often be helped by physical therapy.
In women who feel their sexual life is not satisfactory, the role of diabetic neuropathy is less clear. Illness, vaginal or urinary tract infections, and anxiety about pregnancy complicated by diabetes can interfere with a woman's ability to enjoy intimacy. Infections can be reduced by good blood glucose control. Counseling may also help a woman identify and cope with sexual concerns. (Source: excerpt from Diabetic Neuropathy The Nerve Damage of Diabetes: NIDDK)
The goal of treatment for diabetic neuropathy is to relieve discomfort and prevent further tissue damage. The first step is to bring blood sugar levels under control by diet and medication. Another important part of treatment involves taking special care of the feet. Analgesics, low doses of antidepressants, and some anticonvulsant medications may be prescribed for relief of pain, burning, or tingling. Some patients may find that walking regularly, taking warm baths, or using elastic stockings may help relieve leg pain. (Source: excerpt from NINDS Diabetic Neuropathy Information Page: NINDS)
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