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Reduce Your Risk of Nerve Pain and Damage From Diabetes
If you have diabetes, chances are good that you already have some form of nerve pain or nerve damage, called diabetic neuropathy. "People with diabetes have about a 60% chance of getting neuropathy of any kind," says Dace L. Trence, MD, an endocrinologist and director of the Diabetes Care Center at the University of Washington Medical Center in Seattle. "It's probably an equal risk of getting neuropathy with type 1 and type 2 diabetes."
You may have tingling, pain, or numbness in your feet and hands -- common signs of the diabetic nerve damage called peripheral neuropathy. Or you may have damage to the nerves that send signals to your heart, stomach, bladder, or sex organs, called autonomic neuropathy. Nerve damage can also be "silent," meaning you have no symptoms at all.
Sometimes, nerve damage starts even before a person is diagnosed with diabetes, Trance tells WebMD. "Even somebody with prediabetes may have neuropathy," she says. As many as 57 million Americans have prediabetes -- a condition where blood sugar levels are abnormally high, but not high enough to qualify as diabetes -- says the American Diabetes Association (ADA). Add to that the nearly 24 million Americans already coping with full diabetes, and you can see how common nerve pain may be.
The good news? Many of the risk factors for diabetic neuropathy are under your control. So while you may not be able to prevent nerve pain and damage completely, you may be able to help slow it down. You can reduce your risk of nerve damage and other diabetes complications by keeping your blood sugars under tight control, says the National Diabetes Information Clearinghouse (NDIC).
Trence agrees. "The better the blood sugar control," she says, "the less likely neuropathy is to progress." A healthy lifestyle helps lower your risk of heart disease, stroke, and other diabetes complications, as well. So know your risk for complications, and work to control the ones you can control.
How well are you managing your diabetes?
Take WebMD's Diabetes Health Check to find out.
Are You at Risk for Diabetic Neuropathy?
1. You Have High Blood Sugar.
The risk: Who are the people at highest risk of nerve pain and damage from diabetes? Those who have trouble controlling their blood sugar.
What you can do: Sometimes glucose control is about mind over matter: you may simply need a little help staying motivated, sticking to your exercise program, or learning how to prepare more varied, tasty, healthy meals. But if you're "doing everything right" and still have high glucose levels, you may need to change your plan and start or adjust medications to help better manage your blood sugars.
2. You've Had Diabetes for Many Years.
The risk: Nerve pain and damage is more common in people who have had diabetes for more than 25 years.
What you can do: Do your best to monitor your blood sugar at home as often as advised by your doctor. The NDIC also advises having the A1c test, a blood test that measures your average blood glucose control over the previous 2 to 3 months, at least twice a year. Trence advises taking the A1c more often as an extra measure of control. "I think most of us believe it should be done every 3 to 4 months," she says. "It can vary, but we need to keep on top of things, and it's such a powerful piece of information to have to complement the patient's own blood sugars."
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Important Safety Information About Cymbalta
Antidepressants can increase suicidal thoughts and behaviors in children, teens, and young adults. Suicide is a known risk of depression and some other psychiatric disorders. Call your doctor right away if you have new or worsening depression symptoms, unusual changes in behavior, or thoughts of suicide. Be especially observant within the first few months of treatment or after a change in dose. Approved only for adults 18 and over.
What should I talk about with my healthcare provider?
Patients on antidepressants and their families or caregivers should watch for new or worsening depression symptoms, unusual changes in behavior, thoughts of suicide, anxiety, agitation, panic attacks, difficulty sleeping, irritability, hostility, aggressiveness, impulsivity, restlessness, or extreme hyperactivity. Call your healthcare provider right away if you have thoughts of suicide or if any of these symptoms are severe or occur suddenly. Be especially observant within the first few months of antidepressant treatment or whenever there is a change in dose.
Who should NOT take Cymbalta?
You should not take Cymbalta if:
- You have recently taken a type of antidepressant called a monoamine oxidase inhibitor (MAOI)
- You have uncontrolled narrow-angle glaucoma (increased eye pressure)
- You are taking Mellaril® (thioridazine)
What other important information should I discuss with my healthcare provider?
Before starting Cymbalta, talk with your healthcare provider:
- about all of your medical conditions, including kidney or liver problems, glaucoma, diabetes, seizures, or if you have bipolar disorder. Cymbalta may worsen a type of glaucoma or the control of blood sugar in some patients with diabetes
- about your alcohol use
- if you are taking nonprescription or prescription medicines, including those for migraine, to address a possible life-threatening condition
- if you are taking NSAID pain relievers, aspirin, or blood thinners. Use with Cymbalta may increase bleeding risk
- if you are pregnant, plan to become pregnant during therapy, or are breastfeeding an infant
While taking Cymbalta, talk with your healthcare provider:
- if you have itching, right upper belly pain, dark urine, yellow skin/eyes, or unexplained flu-like symptoms, which may be signs of liver problems. Severe liver problems, sometimes fatal, have been reported
- if you have high fever, confusion, and stiff muscles to address a possible life-threatening condition
- before stopping Cymbalta or changing your dose
- if you experience dizziness or fainting upon standing, especially when first starting Cymbalta or when increasing the dose.
- about your blood pressure. Cymbalta can increase your blood pressure. Your healthcare provider should check your blood pressure prior to and while taking Cymbalta
- if you experience headache, weakness, confusion, problems concentrating, memory problems, or feel unsteady while taking Cymbalta which may be signs of low sodium levels
- if you develop problems with urine flow
If you have any questions, talk to your healthcare provider before taking Cymbalta.
What are the possible side effects of Cymbalta?
In clinical studies of depression, the most common side effect of Cymbalta was nausea. Other common side effects included dry mouth, constipation, decreased appetite, fatigue, sleepiness, and increased sweating. This is not a complete list of side effects.
Other safety information about Cymbalta:
Cymbalta may cause sleepiness and dizziness. Until you know how Cymbalta affects you, you should not drive a car or operate hazardous machinery.
See Prescribing Information for additional Important Safety Information, including Boxed Warning.