Diabetic Neuropathy Treatment Overview

Care Plan
First steps to consider
- See a healthcare provider to get a diagnosis and a treatment plan.
- Treatment usually starts with controlling blood sugar levels.
- Do daily footcare.
- If you’ve been diagnosed with neuropathy, see a provider if your pain worsens or you notice an open sore on your foot.
Emergency Care
Call 911 or go to the ER if you have any of the following symptoms:
- You’ve had diarrhea for more than 2 days.
- You have a wound that won’t heal.
- You have sudden loss of vision.
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Treat
When to see a healthcare provider
If you have diabetes, you should be seeing a healthcare provider routinely to make sure you’re keeping your blood sugar levels under control. This will help prevent diabetic neuropathy from getting worse.
If you have mild numbness without much pain, you may not need to see a provider other than for your routine medical care. If you have pain or numbness that bothers you or you notice sores or wounds on your feet, you need to see a provider to make sure you are not developing an infection.
If you are already on medication for neuropathy and you are still in pain, talk to your provider about other options that you might be able to try.
Getting diagnosed
Diabetic neuropathy can often be diagnosed based on a physical exam and your symptoms. Your provider may do a nerve conduction test, which is an electrical test that measures the health of the nerves. Other tests may be needed if your provider is concerned that your symptoms are related to another condition.
What to expect from your doctor visit
Once you are diagnosed with diabetic neuropathy, your healthcare provider will review your symptoms with you to determine if treatment is needed. If your symptoms are painful, you may be prescribed medication to treat the pain. Common medications for treating nerve pain include antidepressants and anti-seizure medications. Pain killers, or opioids, are not typically prescribed as a treatment for diabetic neuropathy..
Prescription medications for diabetic neuropathy
- Gabapentin (Neurontin)
- Pregabalin (Lyrica)
- Amitriptyline (Elavil)
- Duloxetine (Cymbalta)
- Desvenlafaxine (Pristiq)
- Lamotrigine (Lamictal)
- Valproic Acid (Depakote)
- Oxcarbazepine (Trileptal)
- Lacosamide (Vimpat)
Types of providers who treat diabetic neuropathy
- A primary care provider can diagnose and treat diabetes and peripheral neuropathy.
- An endocrinologist is a doctor who treats diabetes.
- A neurologist may be needed if the neuropathy symptoms are severe.
- A podiatrist can diagnose and treat foot specific problems.
How to manage diabetic neuropathy at home
It is important to see a healthcare provider to treat your diabetes and help prevent diabetic neuropathy from developing and getting worse. But there are some ways to manage the symptoms at home.
If you have burning or tingling pain that is mild, there are some OTC creams that you can try. These include capsaicin cream, which has anti-inflammatory effects, and lidocaine ointment, which has numbing effects. Several oral supplements have also been shown to help symptoms, including alpha lipoic acid and ginkgo biloba.
OTC medications
If you are applying a medicated lotion or cream, wear gloves to avoid getting the medication on other parts of your body.
- Capsaicin cream
- Lidocaine cream or ointment
- Alpha lipoic acid
- Ginkgo biloba
Tips for treating diabetic neuropathy
- Meditation and talk therapy may help you manage the pain from diabetic neuropathy.
- Exercise can help treat mild painful symptoms and also prevent further damage to the nerves.
Wellness and prevention
- Eating healthy meals and exercising can help keep diabetic neuropathy from getting worse.
- While diabetic neuropathy cannot be reversed, controlling blood sugars can help prevent symptoms from worsening over time.
- Taking care of your feet is also important because people with diabetic neuropathy are at risk of developing sores and infections in the feet.
- Checking your feet every day (using a mirror if needed) can help you find problems early when they are most easily treated.
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