Treating The Underlying Cause
There are many different causes of peripheral neuropathy, some of which can be treated in different ways.
For example:
- diabetes can sometimes be controlled by lifestyle changes, such as stopping smoking, cutting down on alcohol, maintaining a healthy weight and exercising regularly
- vitamin B12 deficiency can be treated with B12 injections or tablets
- peripheral neuropathy caused by a medicine you’re taking may improve if the medicine is stopped
Some less common types of peripheral neuropathy may be treated with medicines, such as:
- steroids powerful anti-inflammatory medicines
- immunosuppressants medicines that reduce the activity of the immune system
- injections of immunoglobulin a mixture of blood proteins called antibodies made by the immune system
But the underlying cause may not always be treatable.
What Are The Types Of Diabetes
Diabetes-related neuropathy can damage different nerves throughout your body. Types of diabetes-related neuropathy include:
- Autonomic neuropathy: Damage to nerves that control your organs.
- Mononeuropathy: Damage to a single nerve, such as in your hand or leg.
- Peripheral neuropathy: Most commonly affects your feet and legs and sometimes affects the hands.
- Proximal neuropathy: Leads to weakness in hips, thighs, buttocks and shoulders.
Avoiding Or Quitting Smoking
Diabetes is more common among people who smoke, although researchers are not sure exactly why.
Smoking damages the walls of the arteries, causing fat to build up, narrowing blood vessels, and impeding circulation. Poor circulation contributes to neuropathy.
Smoking also increases the risk of cardiovascular disease, which can lead to a stroke or heart attack. In addition, it may worsen insulin resistance.
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Diabetic Neuropathy: A Position Statement By The American Diabetes Association
R.P.-B. and A.J.M.B. served as co-chairs of the writing committee.
Diabetes Care
Rodica Pop-Busui, Andrew J.M. Boulton, Eva L. Feldman, Vera Bril, Roy Freeman, Rayaz A. Malik, Jay M. Sosenko, Dan Ziegler Diabetic Neuropathy: A Position Statement by the American Diabetes Association. Diabetes Care 1 January 2017 40 : 136154.
Types Of Diabetic Neuropathy
There are four main types of diabetic neuropathy – see below.
People with the condition could have just one or any combination of the types.
Your healthcare team should tell you which areas are affected and give advice on what to do about any symptoms you are having. The type of treatment you need will depend on the type of neuropathy.
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Diabetic Neuropathic Pain Management
Many medications are available for the treatment of diabetic neuropathic pain. Oral agents include antidepressants and anticonvulsant drugs. According to the 2011 guideline issued by the American Academy of Neurology , American Academy of Physical Medicine and Rehabilitation and the American Academy of Physical Medicine and Rehabilitation guideline for the treatment of painful diabetic neuropathy , pregabalin is recommended for treatment of diabetic neuropathic pain. The drug has been proven effective and can improve quality of life. However, physicians should determine if the drug is clinically appropriate for their patients on a case-by-case basis. Gabapentin and sodium valproate should also be considered for diabetic neuropathy pain management.
According to a Cochrane review evaluating gabapentin for chronic neuropathic pain and fibromyalgia, gabapentin leads to significant pain relief in patients with chronic neuropathic pain when compared with a placebo. Although patients frequently experience adverse side effects, these are usually tolerable, and serious side effects were not increased when compared with side effects associated with the placebo.
According to the 2011 AAN/AANEM/AAPMR guideline, dextromethorphan, morphine sulfate, tramadol, and oxycodone should be considered for PDN treatment. No one opioid is recommended over another.
To Care For Your Feet
- Prevent injury by wearing shoes at all times, even when you are indoors.
- Do foot care as part of your daily routine. Wash your feet and then rub lotion on your feet, but not between your toes. Use a handheld mirror or magnifying mirror to inspect your feet for blisters, cuts, cracks, or sores.
- Have your toenails trimmed and filed straight across.
- Wear shoes and socks that fit well. Soft shoes that have good support and that fit well are best for your feet.
- Check your shoes for any loose objects or rough edges before you put them on.
- Ask your doctor to check your feet during each visit. Your doctor may notice a foot problem you have missed.
- Get early treatment for any foot problem, even a minor one.
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Slow Down The Progression Of Nerve Damage
Again, prevention is key to keeping diabetic peripheral neuropathy at bay. The Mayo Clinic advises the following tips to slow nerve damage:
- Follow your doctors recommendations for good foot care
- Keep your blood pressure under control
- Follow a healthy-eating plan
- Get plenty of physical activity
- Maintain a healthy weight
- Avoid alcohol or, if drinking is allowed, drink only in moderation
Making The Right Dietary Choices
A diet rich in fresh fruits and vegetables will provide fiber, vitamins, minerals, and antioxidants. These can boost overall well-being and help keep blood sugar down.
Choosing healthful fats: Nuts, avocados, oily fish, vegetable oils, low-fat dairy products, lean meats, and poultry products contain fats that can benefit the bodys cells.
However, high levels of triglycerides, a type of fat, in the bloodstream can increase the risk of nerve damage, according to NIDDK. Manufactured or added fats, especially trans fats, can increase levels of triglycerides and the risk of having high cholesterol and obesity.
Avoiding excess sugars: Highly refined carbohydrates and sugars, including fructose sweeteners, can cause sharp, sudden spikes and dips in blood glucose. Avoiding these highs and lows is key to managing blood sugar and preventing further nerve damage.
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Home Remedies For Diabetic Neuropathy
There is no known cure for diabetic neuropathy. Treatment for diabetic neuropathy mainly focuses on:
- Slowing progression of a disease
- Relieving pain in different parts of the body
- Managing complications and restoring function
Natural remedy helps in controlling the blood sugar levels and preventing complications. The most effective home remedies to cure diabetic neuropathy are:
Natural Remedies For Diabetic Neuropathy
1. Manage Blood Sugar Levels
The very best thing you can do to help prevent or control neuropathy is to manage your blood sugar levels. Maintaining blood sugar consistently within a healthy range is the most important thing to prevent permanent damage to the nerves, blood vessels, eyes, skin and other body parts before complications develop.
Studies have found that poor blood sugar greatly increases risk for peripheral neuropathy, which accounts for hospitalizations more frequently than other complications of diabetes and also is the most frequent cause of nontraumatic amputations. The best way to do this is through a combination of frequent blood glucose testing, eating a healthy diet, exercising, and working with your doctor to determine if you need diabetes medicine and/or insulin therapy.
2. Follow a Healthy Diet
Your diet has a direct impact on your blood sugar levels, so its the first place to start in order to manage diabetic symptoms and complications. Focus your diet around unprocessed, whole foods, and limit or reduce your intake of refined carbs, added sugars and sugary drinks to help stabilize blood sugar.
As part of your diabetic diet plan, eat plenty high-fiber foods that are packed with nutrients but low in sugar/artificial ingredients, including:
Other helpful tips for managing blood sugar with your diet include:
3. Exercise and Try Physical Therapy
4. Reduce Exposure to Toxins and Quit Smoking
5. Manage Stress
6. Lower Pain Naturally
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Symptomatic And Supportive Treatment
The pain of neuropathy can be distressing, and it can interfere with your quality of life and with your ability to be active. Symptomatic treatment is important, but it does not heal the myelin or the nerve and it does not prevent neuropathy from worsening.
Medications that are often used to control neuropathic pain include antidepressants and antiepileptic drugs . These medications affect nerve activity in a way that can subdue the pain. Generally, the medications must be taken several times per day for pain relief.
Diagnosis Of Diabetic Neuropathy
The diagnosis of diabetic neuropathy may include:
- taking a medical history for symptoms typical of neuropathy
- checking your feet and legs for responses to stimuli such as temperature, light touch, pain, movement and vibration
- checking the reflexes at your ankles and knees
- tests to exclude other possible causes of neuropathy .
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Ways To Treat Diabetic Peripheral Neuropathy
About 60 to 70 percent of people with diabetes have some form of neuropathy, according to the National Institute of Diabetes and Digestive and Kidney Diseases. Why the high number? Diabetes makes it difficult for controlling blood sugar levels. Elevated blood sugar levels can result in permanent damage to feet and hand nerves. Damaged nerves struggle to carry messages between the brain and other parts of the body. Nerve damage in diabetics typically manifests after about 25 years of suffering with elevated blood sugars. If you or a loved one is currently battling the effects of diabetic peripheral neuropathy you can benefit from learning more about the following prevention and treatment tips.
Understanding Neuropathy And Your Diabetes
If you have diabetes, this should be on your radar. Neuropathy is a diabetes complication that causes nerve damage throughout your body. And if left untreated, has the potential to lead to infection and/or amputation of the affected area.
About half of all people with diabetes have some form of nerve damage. It is more common in those who have had diabetes for many years and can lead to various health problems down the line, impacting your quality of life.
But dont panicneuropathy is not inevitable! Keeping your blood glucose levels on target is your best line of defense against neuropathy. You can also manage neuropathy through a healthy diet and consistent exercise routine that fits your lifestyle.
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Is There A Cure For Diabetic Neuropathy
A diabetes diagnosis can be scary. There are a lot of potential problems that can arise from the initial disease. Although diabetics are at risk for developing range serious conditions due to their bodys response to glucose, there are ways to prevent and reduce the risks associated with many of them. That includes neuropathy.
Infection In Legs And Feet
Nerves in the legs and feet are often most affected by neuropathy. This can cause you to lose sensation to your feet and legs. Sores and cuts can go unnoticed and lead to infections.
In some extreme cases, infections can become severe and lead to ulcers. Over time, this can cause irreparable damage to the soft tissue and lead to the loss of toes or even your foot.
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The Best Treatments For Diabetic Neuropathy
Neuropathy involves damage to the nerve cells which are responsible for touch, sensation and movement. Diabetic neuropathy is the nerve damage caused by diabetes. In most cases, the high blood sugar content of people living with diabetes damages the nerves with time. Neuropathy is a common effect of diabetes, and it is estimated that 60 to 70% of people living with diabetes develop some neuropathy at some point in their life.
Unfortunately, nerve damage from diabetes cant be reversed since the body cannot repair damaged nerve tissues. However, some methods can be used to treat nerve damage caused by diabetes.
Prevention Of Diabetic Neuropathy
Be guided by your doctor, but general suggestions to reduce the risk of diabetic neuropathy include:
- Maintain blood glucose levels within the target ranges.
- Exercise regularly.
- Maintain a healthy weight for your height.
- Reduce your blood pressure and lipid levels through diet and lifestyle changes, and medication where appropriate
- Consult your doctor promptly if you have symptoms including pain, numbness or tingling in your hands or feet.
- Have your feet checked at least yearly by your doctor, podiatrist or diabetes educator, or more often if you have signs of problems with your feet or other complications of your diabetes.
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What Is A Microfilament Exam
A microfilament exam is often used in the diagnosis of diabetic neuropathy. This exam uses nylon filaments to help determine your ability to feel pressure.
You will be asked to close your eyes while a healthcare provider presses a filament onto your skin. If you cannot feel the pressure caused by the filament, it may indicate diabetic neuropathy.
A healthcare provider may also order some blood tests to rule out other causes of nerve damage. This may include:
- Test for markers of autoimmune conditions such as antinuclear antibodies that can indicate systemic lupus erythematosus and Sjögrenâs antibodies that can indicate Sjögrenâs syndrome
If your nerve pain cannot be explained by other causes, it becomes more likely that your nerve pain is the result of diabetic neuropathy.
Other tests that may be used to confirm the diagnosis include a nerve conduction velocity test, which measures how long it takes nerves to transmit signals, and electromyography tests, which help assess how well muscles are responding to the signals from nerves. These tests are performed by a physiatrist .
Skin Biopsy And Quantification Of Intra
Skin biopsy of the distal leg with quantification of intra-epidermal nerve fiber density is the gold standard technique to diagnose small fiber neuropathy and it is also recommended for diagnosing DPN . The procedure involves infiltration of subcutaneous local anesthetic and removal of a small skin sample using a punch biopsy tool. The sample must be immediately fixed, prepared and then epidermal innervation is quantified using either immunofluorescent or immunohistochemistry microscopy. The biopsy itself is quick and easy to perform but it is necessary to have suitable laboratory equipment and expertise to analyse. The technique is minimally invasive with a low complication rate, infection occurs in ~1 in 1,000.
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What Is Diabetic Neuropathy
Neuropathy is a complication of diabetes that can lead to problems throughout the body. Diabetes can affect nerves that control movement, sensation and other functions.
If you have diabetes, you can develop nerve problems at any time. Sometimes, neuropathy can be the first sign of diabetes. Significant nerve problems can develop within the first 10 years after a diabetes diagnosis. The risk of developing neuropathy increases the longer you have diabetes. About half of people with diabetes have some form of neuropathy.
Indian Blackberry Or Jamun
Indian blackberry seeds contain glycoside in it. The glycosides present in the seeds prevent the conversion of starch to sugar. Indian blackberry lowers the blood sugar and prevents insulin spikes. Eating 5-6 Indian blackberries in the morning helps in controlling the blood sugar levels. Eat either raw jamun or add a spoon full on jamun seeds powder to a glass of warm water or milk and drink it daily to control diabetes.
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What Causes Diabetic Neuropathy
Diabetic neuropathy is caused by high blood sugar levels sustained over a long period of time. Other factors can lead to nerve damage, such as:
- damage to the blood vessels caused by high cholesterol levels
- mechanical injury, such as injuries caused by carpal tunnel syndrome
- lifestyle factors, such as smoking or alcohol use
Low levels of vitamin B-12 can also lead to neuropathy. Metformin, a common medication used to manage diabetes, can decrease levels of vitamin B-12. You can ask your doctor for a simple blood test to identify any vitamin deficiencies.
Symptomatic Treatment Of Painful
The mainstay of neuropathic pain treatment in DPN is symptomatic treatment. Unfortunately, pathogenetic treatments and good glycemic control have not been shown to improve neuropathic pain . Duloxetine and Pregabalin are the only treatments which have received regulatory FDA approval for the treatment of painful-DPN . Whereas, the United Kingdom National Institute of Clinical Excellence recommend Amitriptyline, Duloxetine, Pregabalin, and Gabapentin as first line therapies for neuropathic pain . A treatment algorithm is shown in Figure 2 .
Figure 2. Treatment algorithm for painful-DPN. Reproduced and permission gained from Tesfaye et al. .
The 2 agonists, i.e., gabapentin and pregabalin, are widely recommended, and prescribed agents for painful-DPN. These agents enact their analgesic effect through modulation of the 2-1 and 2-2 subunits of voltage-sensitive calcium channels . Gabapentin is efficacious for the treatment of pain and sleep interference in painful-DPN but has a high rate of side effects, most commonly dizziness, and somnolence . The reported number needed to treat to achieve pain relief of at least 50%, is 5.9 . Moreover, a network meta-analysis found gabapentin to be the most efficacious and safe therapy for painful-DPN .
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How Effective Are Diabetic Neuropathy Medications
Theres no treatment that can reverse nerve damage caused by diabetes. But each of the medications mentioned above have been shown to improve diabetes-related nerve pain when compared to placebo . Pregabalin, the most studied of the bunch, has been shown to improve pain by at least 30% to 50% in many research studies.
However, there isnt much high-quality research comparing these medications to each other. The effectiveness of these medications varies from person to person.
Oftentimes, its a trial-and-error process to find a medication that works for you. And its recommended to try a medication for approximately 12 weeks before deciding that its not working. If the first medication doesnt help your symptoms, your healthcare provider may suggest adding a second one or switching to a different one.