How to manage diabetic neuropathy?

Question

Hello doctor,

I am reaching out regarding my 27-year-old brother, who has Type 1 diabetes and has recently been diagnosed with diabetic neuropathy. He has been experiencing severe nerve pain, especially in his feet, along with numbness, which has made it difficult for him to perform everyday activities. His most recent lab reports showed an HbA1c of 8.5% and fasting blood glucose levels averaging around 180-200 mg/dL. He is currently managing his diabetes with a basal-bolus insulin regimen, including Lantus 10 units at bedtime and Novorapid adjusted with meals. Additionally, he takes losartan 25 mg daily for blood pressure and atorvastatin 20 mg for cholesterol. Despite these treatments, his neuropathy symptoms have been worsening. He is wondering if improving his blood sugar control could help alleviate some of the pain and numbness. He is also asking whether there are any medications or therapies specifically for diabetic nerve pain that could help him manage his symptoms more effectively. Could you kindly provide advice on how to manage his neuropathy alongside diabetes and any treatment options he should consider?

Please help.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

Your brother’s symptoms can be managed by the following listed below:

Maintaining HbA1c (glycated hemoglobin) levels around 7 percent can help prevent further nerve damage.
For his neuropathy, medications like Gabapentin, Pregabalin, or Duloxetine can be prescribed to alleviate nerve pain.
Check for vitamin D and B12 levels.
Topical treatments like Capsaicin cream or Lidocaine patches may also help.
It is important to monitor blood sugar by adjusting medicine dose or by adding any medications.
Additionally, lifestyle changes like regular exercise, a balanced diet, and proper foot care can help manage both his diabetes and neuropathy symptoms.

I hope this has helped you.

Please feel free to reach me again, in case of further queries.

Thank you.