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Treating the Nerve Damage from Diabetes

Summary & Participants

Treating nerve damage from diabetes requires a two-pronged approach: controlling blood sugar and alleviating the pain caused by peripheral neuropathy. Learn about the latest therapies.

Medically Reviewed On: July 21, 2008

Webcast Transcript

ANNOUNCER: The nervous system of the body is divided into two major parts. The central nervous system consists of the brain and spinal cord, and the peripheral nervous system includes, but is not limited to, the nerves of the arms, hands, legs, feet, and toes. Peripheral neuropathy is the term for damage to the nerves of the peripheral nervous system. It can be caused by a variety of conditions such as vitamin deficiencies or shingles. However, in the United States, it is most commonly found in people with diabetes.

ASTRID ALMODOVAR, MD: Diabetic peripheral neuropathy is caused by chronic high glucose levels in the blood that damage nerve cells. The manifestations can be painful, or an absence of pain. For example, the patient can have burning, tingling sensation, or they could have no pain. They could have anesthesia in certain parts of their body, usually in the legs and the hands.

ANNOUNCER: Diagnosis and treatment of diabetic peripheral neuropathy involves a two-fold approach.

ROY FREEMAN, MD: In any individual who has diabetic peripheral neuropathy, it's absolutely vital to make every attempt to slow the progression and delay the appearance of the features of the peripheral neuropathy. In addition and simultaneously with this, it's vital to treat the symptoms of the peripheral neuropathy.

ANNOUNCER: The first step in delaying the progression of peripheral neuropathy is to control the patient's diabetes. The patient and the healthcare provider can work together to decide the best way to control blood sugar levels.

ROY FREEMAN, MD: Since the nerve damage is a direct consequence of the elevated blood glucose, it's vital that blood glucose be tightly monitored. Patients should control their diet carefully, exercise and also, under medical supervision, appropriately use prescribed medications, both oral medications and insulin, if necessary.

RUSSELL K. PORTENOY, MD: Patients with painful diabetic polyneuropathy have to have frequent measurements of their blood glucose, and also measurement of their hemoglobin A1C. Hemoglobin A1C is an indicator in the blood of how well the person's glycemic control, meaning to say how well their diabetes has been controlled, during the past period of time measured in weeks.

Most people would say that the hemoglobin A1C should be below 7 percent, and that if it goes above 7 or 7.5 percent, then the person needs much more aggressive management.

ANNOUNCER: In addition to controlling the patient's diabetes, there are many options for controlling the most debilitating symptom of DPN: pain.

ASTRID ALMODOVAR, MD: The pain of diabetic neuropathy can impact a patient's life in a very, very negative way. It is a pain sometimes that does not go away. It is something that inhibits or interferes with their ability to sleep, and therefore it's going to go on to cause fatigue, irritability during the day.

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