How is diabetic neuropathy treated?
Diabetic neuropathy has no known cure. Treatment for diabetic neuropathy focuses on:
- Slowing progression of the disease
- Relieving pain
- Managing complications and restoring function
Slowing progression of the disease. Keeping blood glucose levels consistent within a target range can help delay the progression of peripheral neuropathy and may even reduce symptoms you already have. With good glucose control you may reduce your overall risk of diabetic neuropathy by as much as 60%. In addition to blood glucose monitoring, meal planning and physical activity diabetes medicines or insulin will help control blood glucose levels. Discuss appropriate target ranges for your situation with your medical professional.
To help slow nerve damage:
- Keep your blood pressure under control
- Follow a healthy-eating plan
- Get plenty of physical activity
- Maintain a healthy weight
- Stop smoking
- Avoid or limit alcohol consumption
Pain Relief. Doctors usually treat the pain of diabetic neuropathy with oral medications, although other types of treatments may help some people. People with severe nerve pain may benefit from a combination of medications or treatments. Talk with your health care provider about options for treating your neuropathy.
Over-the-counter pain medicines such as acetaminophen and ibuprofen may not work well for treating most nerve pain and can have serious side effects, so many experts recommend avoiding these medications.
Medications used to help relieve diabetic nerve pain include several classes of anti-depressants. You do not have to be depressed for an antidepressant to help relieve your nerve pain.
Anti-depressants that may be helpful include:
- Tricyclic antidepressants, such as amitriptyline, imipramine, and desipramine (Norpramin, Pertofrane)
- Other types of antidepressants, such as duloxetine (Cymbalta), venlafaxine, bupropion (Wellbutrin), paroxetine (Paxil), and citalopram (Celexa)
- Other drugs including anti-convulsants, such as pregabalin (Lyrica), gabapentin (Gabarone, Neurontin), carbamazepine, and lamotrigine (Lamictal) may be prescribed
Opioids and opioid-like drugs, such as controlled-release oxycodone may be prescribed though long-term use of this class of drugs can cause dependency and should be used as an option of last resort.
Some pain relief treatments are applied to the skin and include capsaicin cream and lidocaine patches. Some studies show nitrate sprays or patches and evening primrose oil may also relieve pain.
Acupuncture, biofeedback, physical therapy or treatments that involve electrical nerve stimulation, magnetic therapy, and laser or light therapy may be helpful.
A device called a bed cradle can keep sheets and blankets from touching sensitive feet and legs.