Diabetic Neuropathy - Treatment Overview
Autonomic neuropathy-which affects nerves that
regulate internal functions-can cause problems with 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 treatment:
- 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.6
- 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 abnormal sweating.
Botulinum toxin (Botox) injections may also
help. 5If 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 stockings).
Treatment if the condition gets worse
diabetic neuropathy gets worse, you may have serious
problems such as severe
bladder infections, or
foot problems. In addition to striving for tightly controlled,
target range A1c levels and taking good care of your feet, you may need further treatment
if diabetic neuropathy progresses.
Diabetic neuropathy is a major
risk factor for foot infections or foot
ulcers leading to amputation.7 It is possible to have permanent disfigurement in one or both
of your feet (such as Charcot foot) from diabetic neuropathy. Surgery is
sometimes needed to correct deformed joints that can result from Charcot foot.
See a picture of
Charcot foot .