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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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