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Diabetes Information |
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Treating Painful Diabetic Peripheral Neuropathy
The toes burn and tingle and sharp pains shoot into your legs. The bed sheets feel uncomfortable on the feet as you toss and turn, trying to get some rest. Your feet felt numb throughout the day, but now feel like they are on fire. Nothing seems to help as you watch the hours on the clock pass by, hoping to fall asleep. Burning, numbness, tingling, hot and cold sensations, shooting and electrical pain are common sensations felt at rest in painful peripheral neuropathy. Neuropathy is an abnormality of the nervous system. There are many different types of neuropathy, but the most common neuropathy effecting diabetics is peripheral neuropathy. Diabetic neuropathy is described as a loss of sensation that starts in the tips of the toes and gradually works its way up the legs, and in severe case into the hands. It is sometimes referred to as a stocking glove neuropathy because it progresses as if one was pulling on a stocking. Sixty percent of diabetics have some type of neuropathy in their feet. Five percent of diabetics will experience painful diabetic neuropathy and the incidence increases with age. Over 45% of individuals who have had diabetes for over 25 years will experience some symptoms of painful diabetic neuropathy. The cause of diabetic neuropathy is not clearly understood. Many believe that the damage to the small vessels surrounding the nerves, from the diabetes, causes damage to the nerves. Others believe the increase in blood sugar causes damage to the nerves. Despite the different theories, studies have shown better blood sugar control helps prevent progression of the neuropathy. There are currently no treatments to help reverse diabetic neuropathy. There are no treatments which help reduce the numbness. But, there are many treatments to help decrease the pain associated with the neuropathy. Your doctor may prescribe medications to help with the pain. There are many options, but until recently none were FDA approved for the treatment of painful neuropathy. Cymbalta, duloxetine HCl, was recently approved by the FDA in September of 2004 for use in diabetic peripheral neuropathy at doses of 60 and 120 mg per day. This is the first drug approved for this use. Similar medications, like amitriptyline, desipramine and nortriptyline, have been used to help decrease pain and help with sleep. Gabapentin, also known as Neurontin, has been a successful treatment for painful diabetic neuropathy. Neurontin was originally approved by the FDA for adjunctive use in seizures, but the benefits of this drug for other conditions, like neuropathy, soon became known. The manufacturers of Neurontin were caught up in a controversy regarding their marketing tactics for this off label use. Many physicians still use this drug despite the controversy. Tegretol and Dilantin, common seizure medications, can be used in more severe cases. New treatments include lidocaine 5% cream, acetyl-L-canitine, nerve growth factor and Annodyne , infrared therapy. To help treat painful peripheral neuropathy without prescription medications, consider the following tips: 1. Keep your blood sugar in control: Studies have shown that when blood sugars remain high, or roller coaster from high to low, peripheral neuropathy will worsen. 2. Exercise. This is probably the last thing you wanted to hear. Exercise helps increase circulation and stimulates the growth of new vessels which help slow the progression of the neuropathy. Exercising also helps to increase your pain threshold and to provide a distraction from the nerve pain in your feet. 3. Eat healthy. Besides helping to control your blood sugar, eating a wide variety of fruits and vegetables will add anti-oxidants to your diet. Anti-oxidants will combat the damaging oxidative effects glucose has on your nerves. In particular, try dark-green, leafy vegetables, yellow, orange, and red fruits and vegetables, citrus fruits and tomatoes. 4. Try red pepper powder. Capsaicin is the active ingredient in chile peppers. When applied to the feet it acts as a counter-irritant and can help decrease neuropathic pain. Capsaicin can be purchased at your local drug store. If you cannot afford capsaicin, try mixing 1 tablespoon of dry chile powder with 2 tablespoons of baby powder. Place the mixture in a sock and use the socks at night. 5. Try alpha lipoic acid. ALA is an effective anti-oxidant that has been shown to relieve pain associated with neuropathy in multiple studies. To help relieve pain, the dose must be at least 600mg a day. It is advisable to start with a lower dose, as higher doses can cause nausea, stomach upset, fatigue, insomnia and can lower blood sugar. In general, ALA is a safe supplement. 6. Try gamma linolenic acid. GLA is an essential fatty acid found in evening primrose oil. Most of the studies have shown modest results, but the possibilities are still encouraging. Take 360mg/day. Many indications require higher dosages, but side effects with long term use at higher doses may include inflammation, thrombosis (blood clots), or decreased immune system functioning. Treating painful diabetic peripheral neuropathy is very difficult and many of the above mentioned therapies should be tried and combined. Don't expect any "cures" and make sure you give each therapy a chance to work. Christine Dobrowolski is a podiatrist and the author of Those Aching Feet: Your Guide to Diagnosis and Treatment of Common Foot Problems. To learn more about Dr. Dobrowolski and her book visit http://www.skipublishing.com/ or http://www.northcoastfootcare.com
MORE RESOURCES: Sotagliflozin Shows Benefit When Added to Insulin for Type 1 Diabetes - Managed Healthcare Executive Sotagliflozin Shows Benefit When Added to Insulin for Type 1 Diabetes Managed Healthcare Executive Hemoglobin A1c (HbA1c): What to know if you have diabetes or prediabetes or are at risk for these conditions Harvard Health 3D Printing Could Enable Long-Term Islet Transplantation in Type I Diabetes Inside Precision Medicine Why These Three Wearables Stocks Just Hit The Skids Investor's Business Daily Middle East Diabetes Devices and Therapeutics Market GlobeNewswire England’s successful diabetes prevention program as blueprint for Canada McGill University Diabetes: Swapping diet soda for water boosts chances of remission MedicalNewsToday Islet Cell Therapy Has Potential to Cure Type 1 Diabetes Managed Healthcare Executive 3D-printed pancreas cells could offer the future of diabetes treatment in world-first breakthrough UNILAD Tech Over Decades, A Healthy Lifestyle Outperforms Metformin in Preventing Onset of Type 2 Diabetes The University of New Mexico Prediabetes: Just over 2 hours of exercise a week could reverse it MedicalNewsToday Relationship between free fatty acids and diabetic retinopathy in male patients with type 2 diabetes nature.com The effect of barley savigh consumption on blood sugar among pre-diabetic postmenopausal women nature.com Stem cell therapies for diabetes nature.com How Immune Checkpoint Inhibitors Can Induce Diabetes Yale School of Medicine Painless diabetes patch to replace needle pricks University of Waterloo Magnesium and Diabetes: Benefits, Deficiency, and More HealthCentral Gestational Diabetes Risk Flagged by Gut Microbes Inside Precision Medicine All-cause hospital admissions and incidence of type 2 diabetes among adolescents in Kazakhstan nature.com Identification of circulating inflammation cytokines as a mediator of gut microbiota and type 2 diabetes mellitus: a Mendelian randomization study Diabetology & Metabolic Syndrome Identification of comorbid genes between type 2 diabetes and migraine through peripheral blood single-cell and Mendelian randomization analysis The Journal of Headache and Pain Progression from gestational diabetes to type 2 diabetes can be predicted: Researchers University of Toronto Effects of canagliflozin on cardiovascular disease risk factors in patients with type 2 diabetes: a systematic review and meta-analysis BMC Endocrine Disorders U.S. Pediatric Diabetes Management Market Report, 2033 Grand View Research People with severe diabetes cured in small stem cell trial The Conversation Persian version of diabetes burnout scale among patients with type 2 diabetes: a validation study BMC Endocrine Disorders No more insulin shots? This 3D-printed scientific leap could change diabetes treatment forever The Economic Times Predictmedix AI Expands into Mobile Diagnostics with New AI-Driven Diabetes Screening Platform Business Wire Closed-loop therapy improves glycemic control in pregnant women with T1D Contemporary OB/GYN Tandem Diabetes Care to Announce Second Quarter 2025 Financial Results on August 6, 2025 Business Wire New study suggests a shift in diabetes testing after pregnancy to improve women's health Sinai Health Son’s diabetes diagnosis sent scientist on quest for cure Harvard Gazette Phillip’s diabetes story: “My whole life changed.” Government of Prince Edward Island The rising rate of type 2 diabetes in young New Zealanders is becoming a health crisis The Conversation How to Prevent Alarm Fatigue in Diabetes Healthline People with severe diabetes cured in small stem cell trial Medical Xpress Popular diabetes and weight loss drugs may cause rare, irreversible vision loss: WHO warns The South First Delayed diabetes onset linked to lower cardiovascular, renal risks University of Cincinnati Stopping diabetes at the YMCA cihr-irsc.gc.ca Health Canada approves Tzield – the first ever disease modifying therapy for type 1 diabetes Breakthrough T1D Canada Shubhanshu Shukla’s ISS mission could be a game-changer for diabetes treatment financialexpress.com Diabetes World Health Organization (WHO) Music Duo The War and Treaty on Managing His Type 2 Diabetes—and Getting Healthier Together The Healthy @Reader's Digest New clinical practice guidelines for type 1 diabetes released Breakthrough T1D Canada Diabetes and Depression National Institutes of Health (NIH) | (.gov) ‘Sweat, spike, solve’: Research suggests a new strategy for people with Type 1 diabetes to lower blood sugar after exercise University of Alberta Physicians Looking to Pharmacists for Patient Engagement in Diabetes Management | ADA 2025 Drug Topics |
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