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Diabetic Neuropathy: What You Need to Know

Cause and symptoms of neuropathy

Diabetic neuropathy is a complication of diabetes and usually occurs in association with chronically elevated blood glucose levels. Elevated glucose levels may damage the nerves--usually in the feet and legs--and this can result in pain, discomfort, and/or numbness.

If numbness occurs, it can be very difficult for someone to detect if he/she has a wound on one or both feet, so the symptom of numbness can be particularly dangerous. If someone is not able to feel a puncture of the skin that causes a wound--or the pain that follows—a cut or scratch may be overlooked and eventually become infected.

The symptoms of pain and discomfort can be debilitating for many people but fortunately there are medications that can be taken to help alleviate these symptoms.

Diabetic neuropathy can also cause problems in other parts of your body. Gastroparesis is a condition that arises from damaged nerves in the digestive system, and can cause abdominal discomfort, nausea, vomiting, bloating, particularly after meals. Other gastrointestinal symptoms can include constipation or diarrhea. Nerve damage in other areas of the body can result in incomplete emptying of the bladder, incontinence, or sexual dysfunction. Damage to nerves that regulate blood flow and blood pressure can result in significant blood pressure drops when sitting or standing, causing a person to feel light-headed or even faint, particularly when standing from a sitting or lying position.

Treatment of neuropathy

If you already have nerve damage, there are things that can be done to slow the rate of progression or treat the symptoms. Maintaining good glucose control, as well as healthy blood pressure and cholesterol levels, has been shown to prevent the progression of neuropathy. If you have numbness, you need to be vigilant about examining your feet for any unusual scratches or wounds. A foot self-exam every day will help you avoid further complications.

Neuropathy is not reversible, however, its symptoms are manageable. It is absolutely crucial for people with diabetic neuropathy to discuss the options for treatment with their healthcare professional before trying any treatment. Your doctor will be able to help you find the solution that works for you.

Some of the treatment options include:

  • Antidepressants. It may sound unusual, but researchers have discovered that antidepressants can be very helpful in decreasing the pain of neuropathy. If your doctor prescribes it for you, it does not mean that he or she thinks you’re depressed. The medication works by blocking pain receptors, and usually takes about a month to be effective. There are a number of different antidepressants that can be helpful in the treatment of painful neuropathy, and some have been specifically approved by the Food and Drug Administration to treat neuropathy.
  • Neurontin (gabapentin capsules). This is one of the most commonly used and effective medications to help with pain caused by neuropathy. Neurontin has relatively few side effects, so some people with diabetes may find this medication very helpful.
  • Capsaicin. This is a topical cream applied to areas affected by neuropathy. Since it is a derivative of pepper, it is important that people with diabetic neuropathy find out if they are allergic to the cream before using a significant quantity. Be sure to do a small patch test first.
  • Holistic or alternative treatments. Some people with diabetic neuropathy have found success with other forms of pain management such as biofeedback, meditation, hypnosis, or acupuncture.

The medications outlined above could be helpful in ending the discomfort of neuropathy, but prevention continues to be the number one way of avoiding the discomfort associated with this condition. By keeping tight control over your blood glucose, you may be able to reduce the symptoms associated with neuropathy, or avoid them altogether. By keeping your A1C at 7% or less, you’ll be taking control of your blood glucose, and increasing your chances of avoiding neuropathy.

Page last updated: October 15, 2019