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Treatments can help those with diabetic nerve pain in hands and feet

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[August 26, 2011] (ARA) - In the United States alone 25.8 million children and adults have diabetes. About 25 percent of those with diabetes have pain and numbness from nerve damage which can be disruptive to living a normal life. The good news is new treatments and strategies can help eliminate this pain today and in the future.

Diabetic nerve pain, or neuropathy, is caused by nerve damage over time. This neurologic disorder most often affects the hands and feet. Pain can be a tingling, burning or cramping that disrupts a person's ability to do everyday activities.

Because nerve fibers are very sensitive to high levels of blood sugar, diabetic nerve damage typically occurs slowly. Your risk for diabetic nerve pain is higher if you:
* Have poor blood sugar control
* Have had diabetes a long time
* Have high blood pressure
* Smoke
* Are tall

"When neuropathy strikes, it is painful and can disrupt sleep; because of this it can also lead to mood changes and lower quality of life," says Dr. Vera Bril, a neurologist with the University of Toronto. "Diabetic nerve pain is often unreported and more often untreated, with an estimated two out of five cases not receiving care."



Bril is the lead author of new guidelines from the American Academy of Neurology that outline the most effective treatments for diabetic nerve pain. In addition to taking preventive steps like managing blood sugar levels, eating healthy and exercising, the guidelines found that a number of drugs may also help relieve diabetic nerve pain.

According to the guidelines, strong evidence shows the seizure drug pregabalin is effective in treating diabetic nerve pain and can improve quality of life; however, doctors should determine if it is appropriate for their patients on a case-by-case basis. In addition, the guideline found that several other treatments are probably effective and should be considered, including the seizure drugs gabapentin and valproate, antidepressants such as venlafaxine, duloxetine and amitriptyline and painkillers such as opioids and capsaicin.

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The guideline also studied a number of non-medicine treatments. Only one - transcutaneous electric nerve stimulation, or TENS, a widely used pain therapy involving a portable device - was found to help relieve diabetic nerve pain.

The nerves to the feet are the longest in the body, and this is why the feet are most affected by diabetes-related nerve pain. In order to take good care of your feet, consider the following steps:

1. Clean feet daily using warm water and mild soap.
2. Check feet and toes daily for cuts, blisters or other problems.
3. Keep toenails trimmed and filed smooth.
4. Wear shoes outside and slippers inside to protect feet from injury.
5. Make sure shoes fit well and don't cramp feet.

Nerve pain is a chronic problem for people with diabetes. Visit www.aan.com/patients for more information.

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