There is no cure for diabetes-related neuropathy. However, you can control it with medications, therapy, and tighter blood sugar control. You can help prevent diabetic neuropathy by seeking support for physical activity and following a healthy, balanced diet. Your diet should include all the essential vitamins and minerals, as they can help protect you and repair premature nerve damage.
Other important ways to help delay or prevent the worsening of neuropathy include keeping blood pressure under control, maintaining a healthy weight, and regular physical activity. Diabetic neuropathy cannot be reversed. However, a person can take steps to slow the progression of the condition and control symptoms. While it's not possible to reverse diabetic neuropathy, people can take steps to reduce the risk of serious symptoms and additional complications.
The possible use of VEGF, which can have a direct impact on both nerve blood flow and nerve cells, offers clear advantages over other therapeutic approaches that target either of these tissues separately. The fact that intramuscular transfer of the VEGF gene is a simple method that does not require elaborate techniques makes it a good candidate for future clinical use. Since the lower limb is often ischaemic in diabetes, intramuscular transfer of VEGF can help to control not only nerve but also muscle ischaemia. Diabetic peripheral neuropathy is a progressive disease that is believed to have no effective treatments for reverse it.
Peripheral neuropathy is caused in part by decreased circulation to the hands and feet in diabetic patients. Numbness, tingling, and pain in the hands and feet usually begin several years after the initial onset of diabetes. If the degree of sensory loss worsens enough, it can lead to ulcer formation and, eventually, amputation. Therefore, restoring blood flow in patients with diabetes can restore sensitivity in the hands and feet and potentially reverse neuropathy and, therefore, prevent the formation of ulcers and amputations.
The bottom line is that, unless neuropathy is in its early stage, the condition is largely irreversible. That said, since neuropathy is progressive, there are ways to stop the condition, contain the damage, and make the person more comfortable. It affects the nerves that transmit messages of touch, temperature, pain and other sensations from the skin, bones and muscles to the brain. Although diabetic peripheral neuropathy can affect any part of the body, it most often develops in the lower legs and, less commonly, in the arms and hands.
More specifically, retinal hypoxia in the diabetic state due to reduced blood flow stimulates VEGF expression and results in retinal neovascularization and increased retinal vascular permeability. In streptozotocin-induced diabetic rats, increased VEGF expression has been reported in the sciatic nerve and in the dorsal root ganglia. In a study published in the Journal of The American Podiatric Medical Association (Kochman, Carnegie and Burke, 200), the results of patients with diabetic neuropathy treated with near-infrared monochromatic photoenergy (MIRE) at a Colorado medical clinic were analyzed. Therefore, unlike what occurs in experimental neuropathy described below, the magnitude of the nerve flow alteration is not clear in the case of clinical diabetic neuropathy.
People with diabetes are more likely to be hospitalized with a foot ulcer than with any other complication of diabetes. Serotonin and norepinephrine reuptake inhibitors (SNRIs) are another type of antidepressant that can help relieve nerve pain and have fewer side effects. Finally, it is also a matter of concern that in vitro studies have demonstrated that VEGF activates the PKC pathway, which can contribute to both diabetic retinopathy and neuropathy (Figure 1; see also ref. Surprisingly, the transfer of the VEGF gene 12 weeks after the induction of diabetes completely restored the nerve function anomalies studied both in large fibers and in the small ones.
The American Diabetes Association (ADA) generally recommends glycated hemoglobin (A1C) of 7.0% or less for most people with diabetes. Although the peripheral nerves of diabetic patients are clearly hypoxic, it is not certain whether this hypoxia can cause increased VEGF expression, such as occurs in the muscles and the retina.
