Diabetic Neuropathy

Managing complications and restoring function 

Gastrointestinal Problems.To relieve mild symptoms of indigestion, belching, nausea, or vomiting eating small, frequent meals, avoiding fats and eating less fiber are recommended. With severe symptoms erythromycin may be prescribed to speed digestion, or metoclopramide to speed digestion and help relieve nausea. To relieve diarrhea or other bowel problems, doctors may prescribe an antibiotic such as tetracycline.

Dizziness and Weakness. Sitting, standing or moving slowly may help prevent the light-headedness, dizziness, or fainting associated with blood pressure and circulation problems. Raising the head of the bed or wearing elastic stockings may also help. Some people benefit from increased salt in the diet and treatment with salt-retaining hormones. Others benefit from high blood pressure medications. Physical therapy can help when muscle weakness or loss of coordination is a problem.

Urinary and Sexual Problems. Your doctor will prescribe an antibiotic to treat any urinary tract infections. Drinking plenty of fluids may help prevent another infection. People who have incontinence should try to urinate at regular intervals (every 3 hours) since they may not be able to tell when the bladder is full.

Doctors will do tests to rule out hormonal causes for erectile dysfunction. Medicines are available to help men have and maintain erections by increasing blood flow to the penis. Some are oral medications and others are injected into the penis or inserted into the urethra at the tip of the penis. Mechanical vacuum devices can also increase blood flow to the penis. Another option is to surgically implant an inflatable or semi-rigid device in the penis.

Vaginal lubricants may be useful for women when neuropathy causes vaginal dryness.

Foot Care. People with neuropathy need to take special care of their feet. The nerves to the feet are the longest in the body and are the ones most often affected by neuropathy. Loss of sensation in the feet means that sores or injuries may not be noticed and may become ulcerated or infected. Circulation problems also increase the risk of foot ulcers. More on foot care.

Other Methods to reduce your risk of diabetic neuropathy:

  • Keep your blood pressure under control
  • Make healthy food choices. Eat a balanced diet that includes a variety of healthy foods especially fruits, vegetables and whole grains and limit portion sizes to help achieve or maintain a healthy weight.
  • Be active every day. In addition to helping you achieve a healthy weight, daily activity protects your heart and improves blood flow to the extremities. It also plays a major role in keeping your blood sugar under control. 30 minutes of moderate exercise a day at least five times a week is key to long-term health. However, if you have severe neuropathy and decreased sensation in your legs, your doctor may recommend that you participate in non-weight-bearing activities, such as bicycling or swimming.
  • Stop smoking. If you have diabetes and use tobacco in any form, you’re more likely to develop circulation problems in your feet.

Sources

http://diabetes.niddk.nih.gov/dm/pubs/neuropathies/

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