Dr. Andrew S. Rhinehart, MD discusses assembling your diabetes care team, establishing treatment goals, and screening for the complications of diabetes mellitus. In his book “I Have Diabetes!! Now What?”, available at the www.TheDiabetesExpert.com, he provides more in-depth information regarding assembling your diabetes care team, treatment goals, and screening for complications.
Someone I know is thinkiing about amputating her feet, because the swelling & pain is so-o bad. Please offer any tips, suggestions, etc…
She has edema and neuropathy in both feet.
Your friend needs Mecobalamin (a special vitamin B12) and a anti depressant like tegretol, It helps with pain, Plus a pain killer like Tramadol. This is the key to pain management. I also find that laying down and moving my feet back and forth rapidly relieve pain for split seconds. Medical sock are called for.
And most important , change doctors. Because this one does not care how much pain she is in.
Also she must get blood sugar in control. This is the cause.
What causes diabetic neuropathies?
The causes are probably different for different types of diabetic neuropathy. Researchers are studying how prolonged exposure to high blood glucose causes nerve damage. Nerve damage is likely due to a combination of factors:
metabolic factors, such as high blood glucose, long duration of diabetes, abnormal blood fat levels, and possibly low levels of insulin
neurovascular factors, leading to damage to the blood vessels that carry oxygen and nutrients to nerves
autoimmune factors that cause inflammation in nerves
mechanical injury to nerves, such as carpal tunnel syndrome
inherited traits that increase susceptibility to nerve disease
lifestyle factors, such as smoking or alcohol use
How are diabetic neuropathies treated?
The first treatment step is to bring blood glucose levels within the normal range to help prevent further nerve damage. Blood glucose monitoring, meal planning, physical activity, and diabetes medicines or insulin will help control blood glucose levels. Symptoms may get worse when blood glucose is first brought under control, but over time, maintaining lower blood glucose levels helps lessen symptoms. Good blood glucose control may also help prevent or delay the onset of further problems. As scientists learn more about the underlying causes of neuropathy, new treatments may become available to help slow, prevent, or even reverse nerve damage.
As described in the following sections, additional treatment depends on the type of nerve problem and symptom. If you have problems with your feet, your doctor may refer you to a foot care specialist.
Pain Relief
Doctors usually treat painful diabetic neuropathy with oral medications, although other types of treatments may help some people. People with severe nerve pain may benefit from a combination of medications or treatments. Talk with your health care provider about options for treating your neuropathy.
Medications used to help relieve diabetic nerve pain include
tricyclic antidepressants, such as amitriptyline, imipramine, and desipramine (Norpramin, Pertofrane)
other types of antidepressants, such as duloxetine (Cymbalta), venlafaxine, bupropion (Wellbutrin), paroxetine (Paxil), and citalopram (Celexa)
anticonvulsants, such as pregabalin (Lyrica), gabapentin (Gabarone, Neurontin), carbamazepine, and lamotrigine (Lamictal)
opioids and opioid-like drugs, such as controlled-release oxycodone, an opioid; and tramadol (Ultram), an opioid that also acts as an antidepressant
Duloxetine and pregabalin are approved by the U.S. Food and Drug Administration specifically for treating painful diabetic peripheral neuropathy.
You do not have to be depressed for an antidepressant to help relieve your nerve pain. All medications have side effects, and some are not recommended for use in older adults or those with heart disease. Because over-the-counter pain medicines such as acetaminophen and ibuprofen may not work well for treating most nerve pain and can have serious side effects, some experts recommend avoiding these medications.
Treatments that are applied to the skin—typically to the feet—include capsaicin cream and lidocaine patches (Lidoderm, Lidopain). Studies suggest that nitrate sprays or patches for the feet may relieve pain. Studies of alpha-lipoic acid, an antioxidant, and evening primrose oil have shown that they can help relieve symptoms and may improve nerve function.
A device called a bed cradle can keep sheets and blankets from touching sensitive feet and legs. Acupuncture, biofeedback, or physical therapy may help relieve pain in some people. Treatments that involve electrical nerve stimulation, magnetic therapy, and laser or light therapy may be helpful but need further study. Researchers are also studying several new therapies in clinical trials.
Dr. Andrew S. Rhinehart, MD discusses the potential complications of diabetes mellitus and the importance of screening for and preventing these complications. In his book “I Have Diabetes!! Now What?”, available at the www.TheDiabetesExpert.com, he provides more in-depth information regarding the potential complications of diabetes.
I am 33 and have had diabetes for 25 years. I have not taken good care of myself at all and am now paying the price. I know the big complications… I am now having all these little crazy things happening to me… I am trying to figure out what in the hell is going to happen next. Thanks all.
Diabetic complications can be classified broadly as microvascular or macrovascular disease.
Microvascular complications include neuropathy (nerve damage), nephropathy (kidney disease) and vision disorders (eg retinopathy, glaucoma, cataract and corneal disease).
Macrovascular complications include heart disease, stroke and peripheral vascular disease (which can lead to ulcers, gangrene and amputation). Other complications of diabetes include infections, metabolic difficulties, impotence, autonomic neuropathy and pregnancy problems.
http://www.LifestyleMakeoverEbook.com/diabetes George Tohme outlines the problem of diabetes, pre-diabetes and obesity; and their deadly complications. All can be defeated by making small and balanced lifestyle choices. Never diet again
Dr. Andrew S. Rhinehart, MD discusses assembling your diabetes care team, establishing treatment goals, and screening for the complications of diabetes mellitus. In his book “I Have Diabetes!! Now What?”, available at the www.TheDiabetesExpert.com, he provides more in-depth information regarding assembling your diabetes care team, treatment goals, and screening for complications.
Dr. Andrew S. Rhinehart, MD discusses the potential complications of diabetes mellitus and the importance of screening for and preventing these complications. In his book “I Have Diabetes!! Now What?”, available at the www.TheDiabetesExpert.com, he provides more in-depth information regarding the potential complications of diabetes.
http://www.LifestyleMakeoverEbook.com/diabetes George Tohme outlines the problem of diabetes, pre-diabetes and obesity; and their deadly complications. All can be defeated by making small and balanced lifestyle choices. Never diet again