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Symptoms & Tips for Diabetes Nerve Damage

Peripheral neuropathy can be a painful and difficult-to-treat complication of diabetes. Here's help to manage the frustrating sensations it causes.

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Deborah Grona wasn't sure she'd ever do the two-step again. After years of unrelenting pain from diabetic neuropathy, the 59-year-old medical transcriptionist found herself back on the dance floor last New Year's Eve. Even more surprising, she had forgotten to take her pain medicine that night -- and her feet didn't hurt. "When I sat down, I thought it had to be the excitement of the evening," says Deborah, who lives in San Antonio, runs her own business, and has type 2 diabetes.

The next morning, she awoke shocked to realize that she'd had a good night's sleep and was still feeling no pain in her legs or feet. Maybe the prescription supplement she'd been taking was kicking in. Maybe, after four years, her agony had ended.

A Common Problem
According to The Neuropathy Association, 60-70 percent of all people with diabetes (PWDs) develop peripheral neuropathy, a disorder of the motor, sensory, and autonomic nerves that connect the spinal cord to muscles, skin, and internal organs. The condition typically causes weakness, numbness, tingling, and pain in the hands and feet. About 30 percent of all peripheral neuropathy cases are related to diabetes; even people with prediabetes can develop it.

No one knows exactly what causes the damage. Having high blood glucose for a long time appears to be a major factor, but nerve damage may also come from excess insulin or another metabolic change, says Todd Levine, M.D., codirector of the Peripheral Neuropathy Clinic at Banner Good Samaritan Medical Center in Phoenix.

Medicine Can Help
Just like the symptoms, the course of peripheral neuropathy varies. For some, the pain comes and goes and progresses slowly over years. For others, it is debilitating right away and can worsen quickly.

For Deborah, the troubles began in 2007 with tingling in her feet. It soon turned into pain so persistent that she could not sleep through the night. She cut back her work hours and gave up dancing. She even sold her house because it hurt too much to walk on the ceramic tile. "It felt like someone was holding a blowtorch to my feet," she says.

Unfortunately, there is no cure for damaged nerves. The condition can be controlled with lifestyle strategies and medications. Over-the-counter pain relievers may help, and some people find relief by taking antidepressants, such as amitriptyline (Elavil) or desipramine (Norpramin). The medicine somehow helps block the pain, but it can take several weeks to become effective, if at all.

Some doctors prescribe anticonvulsants, such as pregabalin (Lyrica), for peripheral neuropathy pain. A recent study, however, found that for study participants with "inadequate pain control," the drug didn't significantly lessen nerve pain. Pfizer, the drug's maker, says it will conduct further analyses.

Deborah finally got relief about a year after she started taking Metanx, a prescription pill that contains vitamins B6 and B12 and folic acid. The U.S. Food and Drug Administration classifies Metanx as a medical food. Metanx increases the production of nitric oxide, a vasodilator, which helps improve blood flow and repair damaged nerves. These days, Deborah has cut back on her pain meds. She's also working more hours and dancing the two-step again. To improve her overall health, she is eating better and has started walking on a treadmill twice a day. She said she has noticed a big difference in her feet. "Feeling my toes now is just amazing."


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