By Arturo Ronzon
The goals of treating diabetic neuropathy are preventing and possibly reversing the progression of nerve damage, and reducing the symptoms, targeted therapies to the underlying mechanisms of diabetic neuropathy are essential to slow the progression of the disease. It is clear that symptoms of each of these types of diabetic neuropathy are triggered by a rapid improvement in glycemic control. Although the causes of diabetic neuropathy are not fully known, high blood sugar (hyperglycemia) is believed to be the major causative factor.
Symptoms of diabetic neuropathy depend on the types of neuropathy. The most common symptoms of neuropathy include numbness and loss of feeling, usually in the feet and hands; they also include tickling or pricking pain.
Symptoms include weakness, pain, and numbness, which may be serious enough to interfere with daily activities, they usually develop 10-20 years after the initial diabetes diagnosis, other are stomach problems and muscle weakness. Often, the symptoms are slight at first (The initial symptoms of diabetic neuropathy are pain, tingling and loss of feeling in the feet), but then they increment overtime. An estimated 10 to 65% of those with diabetes have some form of neuropathy, but not all with neuropathy have symptoms. Over 45% of individuals who have had diabetes for over 25 years will experience some symptoms of painful diabetic neuropathy. Some symptoms of diabetic neuropathy are described as a 'stocking and glove' distribution, meaning that the symptoms affect the foot, leg and hand.
Good control of blood sugar levels prevents further nerve damage and can reverse the pain or numbness. Some investigations showed that intensive control of hyperglycemia could prevent or delay the development of diabetic neuropathy. Other than tight glycemic control, no evidence-based treatments currently exist that prevent or ameliorate diabetic neuropathy.
Prevention consists in maintaining tight blood sugar control as the key to eliminating many of the symptoms of diabetic neuropathy. That's why people who don't control (or can't control) their blood sugar very well seem more likely to get diabetic neuropathy. Even in patients with excellent glycemic control, around 20% will still develop painful diabetic neuropathy (PDN).
What's the treatment for diabetic neuropathy?
The goals of treating diabetic neuropathy are to prevent progression and reduce the symptoms of the disease. Although the FDA has recently approved two new agents specifically for the treatment of diabetic neuropathy: duloxetine and pregabalin and they are considering an application to approve acetyl-L-carnitine as a treatment as well, effective therapies for the prevention and treatment of diabetic neuropathy are not currently available. However, if you want to get appropriate treatment you must first talk to your doctor to determine exact type for your diabetic neuropathy.
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