Diabetes Peripheral Neuropathy
Prevention, treatment a possibility
I think it's always best to let my patients' questions guide me. If one of you has a question, someone else probably has the same question. I've received many questions about neuropathy. People want to know what they can do for neuropathy, will their neuropathy get better, and will it lead to amputation. Here are some answers to your questions about diabetes peripheral neuropathy.
What is Diabetes Peripheral Neuropathy?
Neuropathy that affects your legs and feet is known as diabetic peripheral neuropathy (DPN). Learn more about DPN, how it's diagnosed, and how it's treated in several of my articles – Diabetes and Feet-What's the Deal?, The Nerve of Your Feet!, and others.
What's the best treatment for Diabetes Peripheral Neuropathy?
The best thing you can do for DPN is to try to prevent it. Prevention means managing your ABC's and following the diabetes foot care guidelines.
A1C – Manage your blood sugar and keep your A1C below 7%.
B – Manage your blood pressure. Keep your blood pressure <130/80 mmHg
C – Cholesterol (Lipids)
- Total cholesterol <200 mg/dl
- Triglycerides <150 mg/dl
- HDL >40 mg/dl for men, >50 mg/dl for women
- LDL <100 mg/dl, or 70 mg/dl if you have heart disease
When you start to better manage your blood sugar, you may find out that your feet are more painful than they were. This can be because your nerves are starting to "work" again. Hang in there. They should get better.
Besides managing your ABC's other treatments include but are not limited to:
- Over-the-counter pain relievers – acetaminophen, aspirin, and other NSAIDs such as ibuprophen (Motrin) and naproxyn (Aleve).
- Antidepressants – although DPN can cause depression, these medications are not prescribed for depression. They do work on your nervous system and help decrease the pain. o Tricyclic antidepressants-amitriptyline, desipramine, and imipramine
o Other antidepressants-bupropion (Wellbrutrin), citalopram (Celexa), duloxetin (Cymbalta), and paroxetin (Paxil)
- Anticonvulsants-carbamazepine, gabapentin (Cabarone, Neurontin), lamotrigine (Lamictal) pregabalin (Lyrica)
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Many people say that depression is a side effect or complication of diabetes. Without discounting the association of the psychological condition with the physical one, I'm not convinced that our high and/or unstable glucose levels are directly responsible for that change in our mental state. My belief is that the unrelenting need for self-care, for following the sort of care schedules that can drive licensed, professional caregivers crazy, is what overwhelms us...