Good control of diabetes over time is the key to treating There is no cure forbut keeping yoursugar within a target range can reduce symptoms and prevent them from getting worse.
To help control your eat food that is good for you an Controlling diabetes means maintaining blood sugar levels (A1c) within the target range. This will do more than anything else to help preventfrom getting worse.
Initial treatment
Treatment fordepends on your symptoms and the type of neuropathy that you have. In general, treatment focuses on reducing current symptoms and preventing the condition from getting worse by keeping your blood sugar level (A1c) within a narrow You can keep yourwithin the target range by taking youror oral diabetes medicine as prescribed, checking your blood sugar levels, following your exercising, and seeing your doctor regularly. For more information, see the topics Type 1 Diabetes: Living With the Disease or Type 2 Diabetes: Living With the Disease.
Also, it is important to properly care for yourwhen you have diabetic neuropathy. Diabetic neuropathy may cause a loss of feeling in your feet. It is possible for a sore orto go unnoticed. Without proper foot care, an untreated foot sore can lead to a serious infection or possibly amputation. For more information, see:
It is also wise to maintain healthy habits such as seeing your doctor regularly, controlling youreating a balanced exercising regularly, not and limiting or avoiding alcohol. Additional treatment depends on the specific type of diabetic neuropathy that you have along with your current symptoms.
Many people withave mild to severe pain in specific parts of their bodies. Talk with your doctor about treatment that can reduce your pain and improve your physical functioning, mood, and mental well-being. These treatments may include:
such as pain relievers or creams to relieve pain. Prescription medicines often used to reduce pain from diabetic neuropathy may include medicines that are more commonly used to treat such as tricycliand the antidepressanthydrochloride, and medicines that control seizures, such These medicines may be tried to reduce your pain even though you do not have depression or seizures.
therapies such has not been well studied as a treatment for diabetic neuropathy. But some studies show that it may help with pai
such as exercises, stretching, an If you are told to use heat or ice, be careful. Neuropathy can make it hard for you to feel changes in temperature.
which is a type of therapy that reduces pain by applying brief pulses of electricity to nerve endings in the
which affects nerves that regulate internal functions-can affect digestion, urination, sweating, sexual function, blood pressure, and other involuntary body functions. Some symptoms of autonomic neuropathy can be hard to manage, but others respond well to treatment:
Mil Eating small, frequent meals that are high in fiber and low in fat may help. Freque Eating foods that are high in fiber may help. You may need medicines that slow the rate at which digested food and waste travel through the or you may needsuch as
Mild gastroparesis. This is a condition that causes theto empty very slowly. It may get better if you eat small, frequent meals that are low in fiber and fat. Medicines that help the stomach empty more quickly may also be needed. Controlling blood sugar levels may reduce symptoms of gastroparesis. Abnormal sweating. If you sweat a lot, try to avoid intense heat and humidity. If you sweat severely while eating certain foods, anticholinergic medicines may help. But these medicines have side effects that may sometimes be more troublesome than the abnormal sweating.(Botox) injections may also helIf you don't sweat enough, you can use moisturizers to help with dry or cracked skin. Drinking more water can prevent overheating. Try to avoid places that are very hot or very cold. Lack of awareness oflevel. This is also called You can adjust yourand allow your blood sugar levels to be a little bit higher than the target range. Usually it is recommended that you keep your A1c in a target range. Urinary problems.can be treated with antibiotics forand medicines to improvcontrol. Sexual problems. Your doctor may suggest using medicines or devices to improve erections. Or you may need nonprescription lubricants ancreams for For more information, se Blood pressure problems.can be treated with medicines and by wearing support stockings (also called compression stockings). Ongoing treatment
Ongoing treatment forincludes making sure your blood sugar levels stay tightly controlled within a narrow You also need to practice wise health habits such as seeing your doctor regularly, controlling your blood pressure, getting regular exercise, limiting or avoiding alcohol, and not smoking. Also, take good care of your feet so that foot sores anddo not develop. For more information, see:
Other treatment is tailored to your specific symptoms and the type of diabetic neuropathy that you have.
Many people who havwhich affects nerves that supply sensation and touch-have mild to severe pain in specific parts of their bodies. Treatment can reduce pain and improve physical functioning, mood, and mental well-being and may include:
such as nonprescription pain relievers or creams to relieve pain. The most common medicines used to treat symptoms of diabetic neuropathy include anticonvulsantsuch as pregabalin and gabapentin, tricyclic antidepressants, and the antidepressant duloxetine hydrochloride.
therapies such Acupuncture has not been well studied as a treatment for diabetic neuropathy. But some studies show that it may help with pain.
such as exercises, stretching, an If you are told to use heat or ice, be careful. Neuropathy makes it hard for you to feel changes in temperature.
which is a type of therapy that reduces pain by applying brief pulses of electricity to nerve endings in the skin.
which affects nerves that regulate internal functions-can cause problems with digestion, urination, sweating, sexual function, blood pressure, and other involuntary body functions. Some symptoms of autonomic neuropathy can be hard to manage, but others respond well to treatment:
Mild constipation. Eating small, frequent meals that are high in fiber and low in fat may help. Frequent diarrhea. Eating foods that are high in fiber may help. You may need medicines that slow the rate at which digested food and waste travel through the intestines, or you may needsuch as tetracycline, amoxicillin, or metronidazole. Mild gastroparesis. This is a condition that causes the stomach to empty very slowly. It may get better if you eat small, frequent meals that are low in fiber and fat. Medicines that help the stomach empty more quickly may also be needed. Controlling blood sugar levels may reduce symptoms of gastroparesis Abnormal sweating. If you sweat a lot, try to avoid intense heat and humidity. If you sweat severely while eating certain foods, anticholinergic medicines may help. But these medicines have side effects that may
sometimes be more troublesome than the abnormal sweating.(Botox) injections may also helf you don't sweat enough, you can use moisturizers to help with dry or cracked skin. Drinking more water can prevent overheating. Try to avoid places that are very hot or very cold.
Lack of awareness of low blood sugar level. This is also called You can adjust your insulin and allow your blood sugar levels to be a little bit higher than the target range. Usually it is recommended that you keep your A1c in a target range. Urinary problems.can be treated with antibiotics for urinary tract infections and medicines to improve bladder control. Sexual problems. Your doctor may suggest using medicines or devices to improve erections. Or you may need nonprescription lubricants and estrogen creams for vaginal dryness. For more information, se Blood pressure problems.can be treated with medicines and by wearing support stockings (also called compression stockings). Treatment if the condition gets worse
Ifgets worse, you may have serious problems such as sev or foot problems. In addition to striving for tightly controlled,A1c levels and taking good care of your feet, you may need further treatment if diabetic neuropathy progresses.
Diabetic neuropathy is a major risk factor for foot infections or footleading to amputatioIt is possible to have permanent disfigurement in one or both of your feet (such as from diabetic neuropathy. Surgery is sometimes needed to correct deformed joints that can result from Charcot foot. See a picture of
Severe gastroparesis may require other treatment, such as medicines that empty the stomach more quickly or a feeding tube that is inserted into the stomach
Severe bladder infections or other bladder problems, such as loss of control, may require further diagnostic testing and treatments such as medicines or surgery to improve bladder function.
Also, it is common to experience symptoms ofwith any chronic disease, such as diabetes or diabetic neuropathy. Seeking help for depression may improve your overall well-being and aid in the treatment of your condition.
What To Think About
No matter what you or your doctor try, you may not be pain-free. Be clear with your doctor about what is helping and what is not. You and your doctor can work together to find the right combination of medicine and other treatments to help you the most.
GASTROENTEROLOGY AND HEPATOLOGY Faculty Publications July 1, 2008 – June 30, 2009 PEER-REVIEWED MANUSCRIPTS Agrawal A , Roberts J, Sharma N, Tutuian R, Vela M, Castell DO . Symptoms with acid and nonacid reflux may be produced by different mechanisms. Dis Esophagus. 2009;22(5):467-70. Epub 2009 Feb 13. PubMed PMID: 19222535. Kraichely RE, Farrugia G, Pittock SJ, Cas
Stalles de Genève Biblio : Stalles sculptées du XVème siècle, Corinne Charles, Picard, 1999 Stalles de la Savoie médiévale, éd. de l'unicorne, Genève 1991 Stalles au double Credo Les stalles de la Cathédrale Saint-Pierre de Genève, sont dites 'à double Credo' parce-qu'elles sont composées par des couples apôtre-prophète se faisant vis à vis et portant chacun un phylactère ave