How to Manage Diabetic Neuropathy

One of the most common and grave consequences of diabetes is diabetic neuropathy. Diabetic neuropathy or nerve damage may affect as many as half the people with diabetes.[1] Elevated blood sugar levels and high levels of fats in the blood from diabetes, such as triglycerides, can damage nerves over time.[2]  As a result, the nervous system’s signaling can no longer work correctly.[3]

There are different diabetic neuropathies:

Peripheral: Peripheral neuropathy is the most common type of diabetic neuropathy. It affects the peripheral nervous system, resulting in pain and numbness in the extremities, including arms, hands, legs, feet, and toes. Since peripheral neuropathy can cause numbness, someone with diabetes might not feel a foot injury or cut or even a blister that could result in infections, changes in foot shape and bone and joint damage, and ulcers. Foot ulcers are a considerable problem for people with diabetes, often leading to hospitalization. Other peripheral diabetic neuropathy symptoms include: [4]

• A tingling or burning sensation
• Sharp, jabbing pain that may be worse at night
• Serious discomfort from touch
• Muscle weakness

Proximal: Proximal diabetic neuropathy symptoms include pain and numbness in the upper legs, specifically the buttocks, thighs, and hips. Proximal nerve damage typically affects one side of the body and and usually does not spread to the other side. It is more common in men than in women and more common in people older than age 50. Most people with this condition have type 2 diabetes.[5]

Autonomic: In the case of autonomic neuropathy, nerve damage interferes with signal processing between the autonomic nervous system, which controls automatic body functions, including blood pressure, bladder function, and digestion, and the brain. Autonomic diabetic neuropathy symptoms:[6]

·         Rapid heart rate at rest

·         Dizziness occurs when getting up or standing

·         Drop in blood pressure

·         Sweat gland issues resulting in excessive sweating or lack of sweating. Your body may not be able to control temperature as a result

·         Change in bowel movements resulting in constipation or diarrhea

·         Frequent indigestion and poor appetite

·         Loss of bladder control or trouble emptying the bladder

·         Trouble swallowing

Focal: Sudden loss of function in nerves causing pain and weakness of the muscles. Carpal tunnel syndrome is a type of focal neuropathy.

Diabetic nerve damage is irreversible.

Neuropathy caused by diabetes cannot be reversed, since the body cannot naturally repair damaged nerve tissues. You treat neuropathy by managing your diabetes, which means watching keeping your blood glucose level within target range. By staying close to your goal numbers, you can keep nerve damage from getting worse. You also want to:

·         Keep your blood pressure under control

·         Make healthy food choices, especially vegetables, fruits and whole grain

·         Maintain a healthy weight

·        Stay active. the American Diabetes Association says getting 150 minutes of moderate intensity exercise each week can help you manage your diabetes. [7]

Diabetic neuropathy treatment

Diabetic neuropathy treatment includes both prescription and over the counter (OTC) and drugs. Since they do not work for everyone, you may need to work with your healthcare provider trying the different options to find one that works for you.

Prescription pain meds:

·         Anti-seizure medicines: Some medications that are used to treat seizure are prescribed for nerve pain relief. An example is Gabapentin.

·         Antidepressants: Antidepressants also can be prescribed for diabetic neuropathy pain. Like anti-seizure medicines they are not formally used for pain from neuropathy, but for some people they do ease pain.

OTC pain meds

Anti-seizure and antidepressant prescription pain medications may be used with certain OTC pain medications, such as acetaminophen (Tylenol).

OTC creams for diabetic neuropathy treatment

OTC topical creams are another option for diabetic neuropathy treatment to help ease tingling and nerve pain. The skin absorbs the creams to soothe, nourish and reduce pain and discomfort. Such creams typically include ingredients that hydrate the skin and offer a cooling sensation. They offer relief from pain while also supporting overall foot health.

Many of the OTC diabetic foot creams for neuropathy have capsaicin as their key ingredient. Capsaicin, with its analgesic properties, comes from hot chili peppers and is the active compound that creates their characteristic heat. Capsaicin works by temporarily depleting the neurotransmitter that sends pain signals to the brain to provide effective relief for various pain conditions with repeated use.

Menthol is another ingredient found in many OTC topical creams to manage neuropathy.

Menthol is a chemical found naturally in mint plants but also can be produced in a lab. It seems to activate a channel involved in regulating sensory neuropathic pain. [8]  Menthol creams work fast to provide relief.

Products such as EASE-Z Pain Relieving Foot Cream, Diabetic Safe, provides targeted relief from neuropathy symptoms. The OTC product contains capsaicin and menthol to block pain signals and reduce inflammation. EASE-Z Pain Relieving Foot Cream also features Zinc Acetate, an ingredient recognized for its powerful benefits to protect the skin and enhance the healing of minor wounds and sores.

To help nourish skin and deliver long-lasting relief from dry, cracked, itchy discomfort, EASE-Z Pain Relieving Foot Cream also includes as one of its ingredients Shea Butter, known for its rich moisturizing properties. The result is a fast-absorbing non-greasy foot cream that delivers lasting pain relief to improve daily quality of life.

Prescription diabetic foot creams for neuropathy

Lidocaine is another ingredient used for neuropathy. It works by numbing nerves in a specific area making it less sensitive to pain signals. Low dose lidocaine creams and patches are available OTC for relief from minor pain in shoulders, neck and legs. However, more severe nerve pain may require a higher dose of lidocaine, available in prescription only products.

About other health conditions associated with diabetic neuropathy, you may need to see a specialist, for example to prevent or treat heart problems stemming from neuropathy, you will need to see a cardiologist.

Managing diabetes is ongoing to prevent diabetic neuropathy and other health complications associated with the disease. However, if neuropathy should develop, there are options to help ease pain and improve quality of life.