Diabetic Neuropathy Diagnosis & Treatment

 Diagnosis

A doctor is usually able to diagnose neuropathy caused by diabetes through an examination of the body and review your medical history and symptoms.

The doctor will examine your

• Tone and strength in the overall muscles.
• Tendon reflexes
• Sensitivity to vibrations and touch

Alongside the physical examination Your doctor might also perform or prescribe tests that aid in the diagnosis of diabetic neuropathy for example:

• Test of the filament. Your doctor will apply a filament of nylon (monofilament) across the areas of your skin in order to measure your sensitiveness to contact.
• Tests for sensory function. This non-invasive test can be used to determine the nerves and how they react to vibrations and variations in temperature.
• Test for nerve conduction. This test measures the speed at which nerves located in your legs and arms transmit electrical signals. It's commonly used to determine the presence of carpal tunnel syndrome.
• Tests for muscle responses. Called electromyography, this test is usually done using nerve conduction research. It measures the electrical discharges generated within your muscles.
• Tests for autonomic function. Special tests may be conducted to determine how your blood pressure fluctuates as you move around in different locations, and also whether you sweat frequently.

DIABETIC NEUROPATHY

Treatment

Diabetic neuropathy is not a known cure. The main goals of treatment include:

• A slow progression of the disease
• Help relieve discomfort
• Resolve issues and restore function

A slowing of progression of the disease

Maintaining your blood sugar levels within your range of control is a crucial factor in preventing or reducing nerve damage. The right blood sugar management can even help alleviate your symptoms. Your doctor will determine the ideal range of blood sugar for you based on a variety of factors such as your age, you've been suffering from diabetes for as long as your general health.

Blood sugar levels might need to be assessed on an individual basis. But, generally, it is recommended that the American Diabetes Association recommends the following blood sugar targets for the majority of people suffering from diabetes:

• Between 80 and 130 mg/dL that's between 4.4 to 7.2 millimoles per Liter (mmol/L) in the morning before meals.
• less than 180 mg/dL (10.0 mg/L) two hours following meals

Mayo Clinic encourages slightly lower blood sugar levels for the majority of young people who suffer from diabetes as well as slightly higher amounts for those who could be more susceptible to low blood sugar-related problems. Mayo Clinic generally recommends the following blood sugar targets prior to meals:

• Between 80-120 mg/dL (4.4 and 6.7 mg/L) for those 59 years old and under who have no other medical issues
• Between 100-140 mg/dL (5.6 and 7.8 millimol/L) for those aged 60 or older or who suffer from other medical conditions, such as kidney, lung, or heart disease.

Other ways to reduce or stop neuropathy from becoming worse is to keep your blood pressure in check as well as keep a healthy weight, and engage in regular physical exercise.

Relief from the pain

A variety of prescription medicines are available to treat nerve pain caused by diabetes however, they aren't suitable for all people. Before you decide on medication, consult your physician about the advantages and potential adverse effects to figure out which may be most effective for you.

The pain-relieving medications that are prescribed can consist of:

• Anti-seizure medications. Some medications used to treat seizures (epilepsy) can also be employed to relieve nerve pain. The American Diabetes Association recommends starting with pregabalin (Lyrica). Gabapentin (Gralise, Neurontin) is also an option. The side effects can include dizziness, drowsiness or swelling.

• antidepressants. Some antidepressants ease nerve pain, even when you're not depressed. Tricyclic antidepressants can help minor to moderate pain in the nerves. The drugs in this class are desipramine, amitriptyline (Norpramin) as well as imipramine (Tofranil). The side effects of these drugs can be unpleasant and can include dry mouth, and sleepiness.

  Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs) are two different kinds of antidepressants that can aid in relieving nerve pain, and also have less adverse consequences. They are recommended by the American Diabetes Association recommends duloxetine (Cymbalta) as the initial treatment. Another treatment that is available is Venlafaxine (Effexor XR). Some possible side effects could include nausea dizziness, sleepiness as well as constipation and decreased appetite.

In some instances, antidepressants could be coupled with an anti-seizure medicine. The drugs may be combined with pain-relieving medications, like an over-the-counter medicine such as Acetaminophen (Tylenol other brands) and ibuprofen (Advil, Motrin IB other) or a patch for the skin made of lidocaine (a drug that numbs the body).

Resolving issues and getting back to function

To deal with problems, you may require help from a variety of specialists, like an expert who treats urinary tract issues (urologist) and a heart specialist (cardiologist) who can assist in preventing or treating problems.

The treatment you'll need will depend on the neuropathy-related complication that you are suffering from:

• Urinary tract disorders. Some drugs affect bladder function, and your doctor might recommend discontinuing or switching medications. An exact urination schedule or urinating at least every couple of hours (timed the urination) when pressing gently on your bladder region (below the belly button) could help with some bladder issues. Other methods, including self-catheterization, may be needed to remove urine from a nerve-damaged bladder.

• Digestive disorders. To relieve mild symptoms and signs of gastroparesis, such as nausea, belching, indigestion or vomiting -- physicians recommend eating smaller meals, with more frequent eating. Changes in diet and medication can assist in relieving gastroparesis, diarrhea constipation, nausea and gastroparesis.

• Low blood pressure when sitting (orthostatic hypotension). Treatment starts by making simple changes to your lifestyle like abstaining from alcohol, drinking lots of fluids, as well as changing your position like standing or sitting at a steady pace. A mattress with the head of the bed elevated 6 to 10 inches can help reduce blood pressure swings. Your physician may also suggest abdominal compression support (abdominal binder). Different medications, used in combination or as a single, can be prescribed in order to manage orthostatic hypotension.

• sexual problems. Medications taken by injection or by mouth may enhance sexual performance in certain men, but they're not efficient and safe for all men. Vacuum machines can increase the flow of blood to the penis. Women can find relief using vaginal fluids.