Is Nerve Damage a Complication of Diabetes?

Treatment of Diabetic Neuropathy With Medications

As there is no cure for diabetic neuropathy, Mayo Clinic states that there are three treatment goals for this condition:

1. Slowing the progression.
2. Minimizing pain.
3. Minimizing complications and restoring function.

As you can imagine, much of this involves controlling blood glucose levels. However, your physician may also require you to take medications to control your blood pressure as well as cholesterol.

To treat pain associated with neuropathy, you there are many options available:

• Anti-seizure medications. Although they are used to control seizure disorders, they are also known to treat pain associated with nervous system disorders. Examples include gabapentin (Neurontin), pregabalin (Lyrica), and carbamazepine (Tegretol).
• Antidepressants. These medications are used to treat depression, but also can be used to treat mild to moderate pain “by interfering with chemical processes in your brain that cause you to feel pain.” Examples include amitriptyline, desipramine (Norpramin), and imipramine (Tofranil).

For men who experience sexual dysfunction associated with neuropathy, your physician may prescribe medications such as sildenafil (Viagra), tadalafil (Cialis), or vardenafil (Levitra).

Natural Treatment of Diabetic Neuropathy

At the risk of sounding like a broken record… the best way to treat diabetic neuropathy is to keep your blood glucose levels under control! If you haven’t been consistent with taking your insulin and/or your medication, begin now. Keep blood glucose logs and record your insulin doses and when you take your medications, and share these logs with your medical team so they can make adjustments to your regimen as indicated.

Ask your physician for a referral to speak with a registered dietitian (RD). An RD can create a meal plan that is both heart healthy and will promote glucose control. If you have other comorbid conditions, they can help with that too!

And while you’re at it – get moving! The American Diabetes Association recommends 30 minutes of exercise on most days of the week. Exercise can keep your blood glucose and blood pressure levels under control. Keep in mind if your neuropathy is severe, your physician may have specific exercise recommendations, so speak with your doctor before beginning an exercise routine.

Options to Help Relieve Diabetic Neuropathy Naturally

To relieve pain, here are some alternative remedies that you can try:

• Capsaicin cream. This cream is made out of the same “spicy” stuff that is in chili peppers! It is applied topically to areas of pain.
• Acupuncture. This is thought to relieve pain associated with neuropathy. It typically requires more than one session to provide relief.
• Alpha-lipoic acid. This is an antioxidant that is found in certain foods and may reduce the pain associated with neuropathy. It can be found in broccoli, yams, spinach, potatoes, yeast, tomatoes, Brussels sprouts, carrots, beets, rice bran, and red meat. It is an unproven treatment, so there is no “recommended amount” if you choose to take it in supplement form, but one study indicated that 600 milligrams daily was beneficial.

Can Diabetic Neuropathy be Reversed?

The nerve damage associated with diabetic neuropathy is irreversible.

However, nerve damage can be slowed considerably. For example, it is not uncommon for a person who has not been to the doctor for many years to have “tingling” in their feet as their first symptom of diabetes. They present to a doctor (or the emergency department!) and find that they have diabetes – and neuropathy! With proper treatment, they quickly control their diabetes, as well as their neuropathy symptoms.

Does this mean that their neuropathy has gone away? No, not at all. It means that they have controlled it – and perhaps halted its progression for the time being.

Is Diabetic Neuropathy a Complication of Untreated Diabetes?

Yes, absolutely. But not everyone with diabetes goes on to develop diabetic neuropathy. And not every neuropathy is related to diabetes.

It is a misconception that someone with peripheral neuropathy must have diabetes. There are many other causes of peripheral neuropathy:

• Alcoholism.
• Certain autoimmune diseases, such as lupus, Sjogren’s syndrome, rheumatoid arthritis, Guillain-Barre syndrome, necrotizing vasculitis, and chronic inflammatory demyelinating polyneuropathy.
• Exposure to certain toxins, such as heavy metals and chemicals.
• Trauma to the nerves, such as in a motor vehicle accident.
• Certain medications, such as chemotherapy.
• Specific infections, such as Epstein-Barr virus, diphtheria, HIV, Lyme disease, shingles, leprosy, and shingles.
• Certain inherited neuropathies, such as Charcot-Marie-Tooth disease.
• Developing a tumor that presses on the nerves can cause neuropathy.
• Vitamin deficiencies, especially vitamins B-1, B-6, B-12, vitamin E, and niacin, can all cause neuropathy.
• Bone marrow disorders such as monoclonal gammopathies, osteoclastic myeloma, and lymphoma, are all likely to cause neuropathy.

How to Prevent Diabetic Neuropathy

Unfortunately, sometimes diabetic neuropathy is unavoidable. However, there is one major thing that you can do to prevent diabetic neuropathy.

Do your best to control your blood glucose levels!

Your treatment plan is individualized to you by your medical team. This may mean taking insulin, oral medications or injectable medications (or a combination of any of the above). Regardless of the type of diabetes you have, it also likely means a healthy diet and exercise. And following your treatment plan (and altering it with your medical team when it isn’t working) will give you the best chance at preventing diabetic neuropathy.

Part of keeping your blood glucose levels in check is getting your A1c monitored routinely. The American Diabetes Association recommends getting your A1c drawn at least twice yearly, although your physician may prefer to have it drawn every three months.

Having a foot exam yearly by your physician is also recommended. Why? Because foot problems are sometimes one of the first signs of peripheral neuropathy. You can also perform diabetic foot care at home:

• Check your feet daily. Check for cuts, scrapes, blisters, redness, and swelling. Ask a friend or family member for help if you can’t see your whole foot, or use a mirror if you need to. If anything looks unusual, let your physician know.
• Keep your feet clean and dry. Use lotion if your feet are dry, but avoid using lotion between your toes.
• Wear clean, dry socks and shoes that fit well. Shoes that are too big or too small can cause blisters and cuts. A podiatrist can help if you need assistance obtaining properly fitted shoes.

The Bottom Line…

Prevention of diabetic neuropathy is of the utmost importance – but as we discussed, sometimes it is inevitable. Adequate blood glucose control is important in the case of prevention and in the case of neuropathy treatment. Also, know that there are ways to treat neuropathy so that you can feel your best – but part of treatment involves you, too!