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House Calls: Diabetic neuropathy

Diabetic neuropathy is damage to nerves that occurs because of elevated blood sugar. Symptoms can range from mild to severe.

Neuropathy is the most common complication of diabetes. Signs and symptoms of diabetic neuropathy include: numbness or tingling in the feet and legs, pain or burning sensation of the feet, and loss of sensation in the toes or feet. Numbness can also occur in the arms and hands but it is much less common.

Diabetic neuropathy is diagnosed by symptoms, history and physical exam. There are other tests that help confirm the diagnosis. A nerve conduction test measures the speed that nerve impulses go through muscles. In diabetic neuropathy the conduction of the nerves is slower.

About 50 percent of patients with diabetes will develop neuropathy. Diabetic neuropathy cannot be cured but there are treatments that can alleviate some of the symptoms and can slow the progression of the disease. Also another goal is to keep your blood sugar under control which will help the neuropathy from worsening.

Some prescription antidepressants and anti- seizure medications can help in relieving the pain. Cymbalta is an antidepressant that can relieve neuropathy in some people. Tricyclic antidepressants such as Pamelor and Norpramin have also been used. Anti-seizure drugs such as Neurontin, Tegretol and Lyrica also work to relieve some of the pain in diabetic neuropathy. Some patches that contain Lidocaine have also been used. Capsaicin cream is an over the counter cream that may also be used.

Using devices to keep blankets off the feet at night can help with sensitive feet. Heating pads and cold packs have been used; however, be careful to avoid freeze and burn injuries due to the feet not having adequate sensation. Exercises, stretching and massage are a few more ways to help relieve pain.

Keeping your sugar under control is the best way to prevent or stop neuropathy. Diabetics should avoid smoking, exercise regularly, and eat a healthy diet to have the best long term outcomes.

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