How to manage diabetic neuropathy along with type 1 diabetes?

Question

Hello doctor,

I am reaching out regarding my 27-year-old brother, who has type 1 diabetes and has recently been diagnosed with diabetic neuropathy. He has been experiencing severe nerve pain, especially in his feet, along with numbness, which has made it difficult for him to perform everyday activities.

His most recent laboratory reports showed an HbA1c of 8.5 percent and fasting blood glucose levels averaging around 180 to 200 mg/dL. He is currently managing his diabetes with a basal-bolus insulin regimen, including Lantus 10 units at bedtime and Novorapid adjusted with meals.

Additionally, he takes Losartan 25 mg daily for blood pressure and Atorvastatin 20 mg for cholesterol. Despite these treatments, his neuropathy symptoms have been worsening. He is wondering if improving his blood sugar control could help alleviate some of the pain and numbness.

He is also asking whether there are any medications or therapies specifically for diabetic nerve pain that could help him manage his symptoms more effectively. Could you kindly provide advice on how to manage his neuropathy alongside diabetes and any treatment options he should consider?

Please suggest.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

It is better to plan NCV (nerve conduction velocity) for further management.

Managing diabetic neuropathy and improving blood sugar control -

1. Tighten blood sugar targets: Aim for an HbA1c (glycated hemoglobin) below seven percent to help alleviate neuropathy symptoms.

2. Adjust insulin regimen: Consider consulting a diabetes educator or endocrinologist to optimize the basal-bolus insulin regimen.

3. Continuous glucose monitoring (CGM): Utilize CGM (continuous glucose monitoring) to track blood glucose levels and make informed decisions.

Medications for diabetic nerve pain -

Take various medicines like Pregabalin, Gabapin, and Triptan depending on clinical evaluation, obviously under medical supervision.

Alternative therapies -

1. Physical therapy: Gentle exercises and physical therapy can help improve mobility and reduce pain.

2. Acupuncture: This alternative therapy has shown promise in reducing neuropathic pain.

3. Transcutaneous electrical nerve stimulation (TENS): A non-invasive therapy that can help manage pain.

Lifestyle modifications -

1. Exercise regularly: Engage in gentle exercises, such as yoga or swimming, to improve mobility and reduce pain.

2. Maintain a healthy diet: Focus on whole, nutrient-dense foods to support overall health.

3. Manage stress: Engage in stress-reducing activities, such as meditation or deep breathing.

I hope this helps.

Thank you and take care.