The ADA recommends duloxetine (Cymbalta, Drizalma Sprinkle) as a first treatment. Another medication that can be used is venlafaxine (Effexor XR). There are many prescription medications available for diabetes-related nerve pain, but they don't work for everyone. When considering taking any medication, talk to your healthcare provider about the benefits and possible side effects to determine which one might work best.
for you. Serotonin and norepinephrine reuptake inhibitors (SNRIs) are another type of antidepressant that can help relieve nerve pain and have fewer side effects. Possible side effects include nausea, drowsiness, dizziness, decreased appetite, and constipation. Neuropathy is one of the main causes of morbidity in patients with diabetes 17,18. Numerous drug treatments, both approved and unapproved, have been used to reduce pain associated with DPN and improve patients' quality of life, 53—55. These treatments include antidepressants, anticonvulsants, pain relievers, and topical medications.
The guidelines of the AANs recommend the anticonvulsant drug pregabalin as a first-line treatment. Other suggested treatments, such as venlafaxine, duloxetine, amitriptyline, gabapentin, valproate, and opioids (i.e., the cost of pregabalin, both brand name and generic), is higher than the other drugs on this list. It's also a controlled substance, so opportunities to save vary by pharmacy. Gabapentin (Neurontin) is similar to pregabalin, but it's a little cheaper.
It's not approved by the FDA to treat diabetic neuropathy, but it's usually used in an unauthorized way for this purpose. It is often recommended as another first-choice option. If pregabalin, gabapentin, or duloxetine are not possible options, other options are also available. There is no treatment that can reverse nerve damage caused by diabetes.
However, each of the medications mentioned above has been shown to improve diabetes-related nerve pain compared to placebo (a pill without medication). In many research studies, pregabalin, the most studied of the group, has been shown to improve pain by at least 30 to 50%. Even so, pregabalin and duloxetine are often the best options for managing symptoms, as they are approved by the FDA to treat pain caused by diabetic neuropathy. Gabapentin also is an ideal option.
However, the answer may be more complicated if other factors are included. Diabetic neuropathy is a type of nerve damage caused by diabetes. Many medications, such as pregabalin, duloxetine, and gabapentin, are often used to help control this pain. However, these medications differ in terms of cost, side effects, and other conditions.
of health that they can treat. Studies on medications used to treat diabetic peripheral neuropathic pain evaluate efficacy primarily by measuring pain reduction. Few studies have examined the effects of diabetic peripheral neuropathic pain on quality of life. However, one study used the Nottingham Health Profile, a validated quality of life questionnaire, to examine the quality of life of patients with diabetic peripheral neuropathic pain 31. The study showed a decrease in quality of life in the areas of sleep, energy and exercise tolerance, as well as an increase in emotional reactivity, suggesting significant benefits of treating diabetic peripheral neuropathic pain.
As with many chronic conditions that interfere with quality of life, patients with diabetic peripheral neuropathic pain can explore complementary and alternative medicine (CAM) options. Complementary and alternative medicine therapies are being applied to diabetic peripheral neuropathic pain, although data are limited. Asking patients about the complementary and alternative medicine treatments they use can help doctors provide more comprehensive patient care. The most promising complementary and alternative medicine therapies include l-carnitine and alpha-lipoic acid, which are available without a prescription. Early studies have shown positive results, but more long-term data are needed.
22,45 Data related to acupuncture are limited. However, a pilot study and a small RCT have shown promise, 24,25 A Cochrane review is currently under way 26. Tramadol is a potent morphine-related pain reliever that can be used to treat neuropathic pain that doesn't respond to other treatments that a GP may prescribe. Studies suggest that diabetic peripheral neuropathic pain is related to an unbalanced release of noradrenaline and serotonin by neurons. The drugs listed below are commonly used for the symptomatic treatment of diabetic neuropathy.
People can take several steps at home to ease the pain and discomfort caused by diabetic neuropathy, a possible complication of diabetes. Pregabalin (Lyrica) is approved for the treatment of pain caused by generalized diabetic peripheral neuropathy and can be considered as a first-line agent for diabetic peripheral neuropathic pain. Relationship between type 1 diabetes and type 2 diabetes diagnosed during childhood and adolescence with complications during adolescence and early adulthood. The effect of intensive diabetes treatment on the development and progression of long-term complications in insulin-dependent diabetes mellitus.
Corneal confocal microscopy detects an improvement in corneal nerve morphology with an improvement in risk factors for diabetic neuropathy. Painful diabetic peripheral neuropathy (DPN) occurs in approximately 30% of patients with diabetes mellitus who are hospitalized and in 25% of patients with diabetes who receive treatment in the office. Multicenter study of the incidence and predictive risk factors of neuropathic ulceration of diabetic foot. Physicians should carefully consider the patient's goals and functional status, as well as the potential adverse effects of medications, when choosing a treatment for painful diabetic peripheral neuropathy.
Approximately 10 to 20 percent of patients with diabetes have diabetic peripheral neuropathic pain, which is severe burning, tingling, or discomfort that worsens at night. Other ways to treat diabetic neuropathy include keeping blood sugar levels within a healthy range and maintaining a healthy weight and blood pressure.
