Diabetic Neuropathy (cont.)

Diabetic neuropathy is usually presumptively diagnosed clinically by the patient's symptoms, medical history, and physical exam. However, there are other tests that can definitively diagnose the condition by actual measuring the loss of nerve function. Nerve conduction studies measure the speed of nerve signals in the arms and legs while electromyography measures the electrical discharges produced in muscles. Other tests (sensory, autonomic) may be done on some patients. About 45% to 50% of all patients with diabetes are eventually diagnosed with some form of neuropathy.

While diabetic neuropathy cannot be cured, there are treatments available to help manage some of the symptoms. Another treatment goal is keeping blood glucose levels under good control so that the neuropathy does not worsen.

The pain of diabetic neuropathy can sometimes be managed with certain medications. Certain prescription antidepressants and antiseizure medications have been shown to be effective in relieving pain that originates in the nerves.

For example, duloxetine (Cymbalta) is an antidepressant that can relieve the pain of diabetic neuropathy in some people. The tricyclic antidepressant drugs, including nortriptyline (Pamelor, Aventyl) and desipramine (Norpramin), have also been used for this purpose.

Anti-seizure drugs such as gabapentin (Neurontin), carbamazepine (Tegretol), and pregabalin (Lyrica) are drugs that can also work to relieve pain in people with diabetic neuropathy.

In severe cases, opioid analgesic medications may be needed.

Other kinds of treatment for nerve pain include patches containing the topical anesthetic agent lidocaine. Capsaicin cream is an over-the-counter topical agent that has been shown to relieve nerve pain.

Medications can also help manage the troublesome symptoms of autonomic neuropathy. For example, antispasmodic or anticholinergic drugs can help prevent urinary incontinence. Drugs to treat erectile dysfunction like sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra) may help some men with ED due to diabetic neuropathy. For women, vaginal estrogen creams and lubricants may provide relief of vaginal dryness and irritation.

Botulinum toxin (Botox) injections have been used to treat abnormal sweating.

Source: MedicineNet.com
http://www.medicinenet.com/diabetic_neuropathy/article.htm