Diabetic Neuropathy - Treatment Overview
Autonomic neuropathy-which affects nerves that
regulate internal functions-can affect digestion, urination, sweating, sexual
function, blood pressure, and other involuntary body functions. Some symptoms
of autonomic neuropathy can be hard to manage, but others respond well to
- Mild constipation.
Eating small, frequent meals that are high in fiber and low in fat may
- Frequent diarrhea. Eating foods that
are high in fiber may help. You may need medicines that slow the rate at which
digested food and waste travel through the intestines, or you may need
antibiotics such as tetracycline, amoxicillin, or
- Mild gastroparesis. This is a
condition that causes the stomach to empty very slowly. It may get better if
you eat small, frequent meals that are low in fiber and fat. Medicines that
help the stomach empty more quickly may also be needed. Controlling blood sugar
levels may reduce symptoms of gastroparesis.
- Abnormal sweating. If you
sweat a lot, try to avoid intense heat and humidity. If you sweat severely
while eating certain foods, anticholinergic medicines may help. But these
medicines have side effects that may sometimes be more troublesome than the
Botulinum toxin (Botox) injections may also
help.5 If you don't sweat enough, you can use
moisturizers to help with dry or cracked skin. Drinking more water can prevent
overheating. Try to avoid places that are very hot or very cold.
- Lack of awareness of low blood sugar level. This is also called
hypoglycemia unawareness. You can adjust your insulin
and allow your blood sugar levels to be a little bit higher than the target
range. Usually it is recommended that you keep your A1c in a target range.
- Urinary problems.Urinary problems can be treated with antibiotics for urinary tract infections
and medicines to improve bladder control.
- Sexual problems. Your doctor may suggest using medicines or devices to improve
erections. Or you may need nonprescription lubricants and estrogen creams for
vaginal dryness. For more information, see
- Blood pressure problems.Blood pressure problems can be treated
with medicines and by wearing support stockings (also called compression
Ongoing treatment for
diabetic neuropathy includes making sure your blood
sugar levels stay tightly controlled within a narrow
target range. You also need to practice wise health
habits such as seeing your doctor regularly, controlling your blood pressure,
getting regular exercise, limiting or avoiding alcohol, and not smoking. Also,
take good care of your feet so that foot sores and
other foot problems do not develop. For more information, see:
- Diabetes: Taking Care of Your Feet.
Other treatment is tailored to your specific symptoms
and the type of diabetic neuropathy that you have.
who have peripheral neuropathy-which affects nerves that supply
sensation and touch-have mild to severe pain in specific parts of their bodies.
Treatment can reduce pain and improve physical functioning, mood, and mental
well-being and may include:
- Medicines such as nonprescription pain
relievers or creams to relieve pain. The most common medicines used to treat
symptoms of diabetic neuropathy include anticonvulsant drugs such as pregabalin
and gabapentin, tricyclic antidepressants, and the antidepressant duloxetine
- Complementary therapies such as
acupuncture. Acupuncture has not been well studied as
a treatment for diabetic neuropathy. But some studies show that it may help
- Physical therapy such as exercises, stretching, and
massage. If you are told to use heat or ice, be
careful. Neuropathy makes it hard for you to feel changes in
- Transcutaneous electrical nerve stimulation (TENS),
which is a type of therapy that reduces pain by applying brief pulses
of electricity to nerve endings in the skin.