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Diabetic Neuropathy: Treatment, Procedure, Cost and Side Effects

What is the treatment? How is the treatment done? Who is eligible for the treatment? (When is the treatment done?) Who is not eligible for the treatment? Are there any side effects? What are the post-treatment guidelines? How long does it take to recover? What is the price of the treatment in India? Are the results of the treatment permanent? What are the alternatives to the treatment?

What is the treatment?

Neuropathy is the damage caused to the nerves. Diabetic neuropathy on the other hand is nerve damage which occurs due to diabetes. This is because of the prolonged levels of blood sugar which may cause damage to the nerves. Diabetic neuropathy affects various parts of the body and is the most common impediment of diabetes. Diabetic neuropathy usually creates immense pain on one side of the body and in the thighs, buttocks and hips. It can also cause weakness in the leg. Diabetic neuropathy can be of many types, diabetic peripheral neuropathy affects the nerves of the legs and feet, diabetic proximal neuropathy affects the buttocks, hips and thighs and diabetic focal neuropathy affects specific nerves at any area of the body. There is another form of diabetic neuropathy called diabetic autonomic neuropathy which affects the nerves in the vascular system, genital, urinary and gastrointestinal system.

Though diabetic neuropathy cannot be cured, the symptoms can be relieved with the help of certain medications and therapies. You can also keep blood sugar levels under control with the help of medication and diet so that the symptom of the diabetic neuropathy doesn’t worsen. Pain can be managed with the help of certain medications such as anti-seizure medications and antidepressants.

How is the treatment done?

Diabetic neuropathy is generally diagnosed with the help of tests, physical exam and medical history. However tests that measure the loss of nerve functioning can also diagnose diabetic neuropathy. Nerve conduction studies are used to measure the speed of the signals of the nerve to the legs and arms. Electromyography is a method that measures the electrical discharge which is produced in the muscles. Nervous system functioning and blood sugar tests are also done to diagnose this disorder. According to studies, 45% to 50% people who have diabetes suffer from diabetic neuropathy. Many patients also use capsaicin cream as an over the counter medicine to relieve nerve pain temporarily. Opioid analgesic medicines can also be needed in severe cases.

The most common medications include anti-seizure and anti-depressant medicines to relieve the pain caused due to diabetic neuropathy. Tricyclic anti-depressants such as desipramine (Norpramin) and nortiptyline (Pamelor Aventyl) are used to relieve symptoms. Anti-seizure drugs like pregabalin (Lyrica), carbamazepine (Tegretol) and gabapentin (Neurontin). These medicines should only be consumed in moderation by a doctor’s prescription. These drugs can also help to manage symptoms of autonomic neuropathy like urinary incontinence or erectile dysfunction. These drugs include varenafil (Levitra), tadalafil (Cialis) and sildenafil (Viagra).

Who is eligible for the treatment? (When is the treatment done?)

Antidepressants or anti-seizure drugs should be taken in tablet form or can also be crushed and mixed in water during consumption. Other than depression and panic attacks, those who suffer from diabetic neuropathy are ideal candidates to consume antidepressants. However, it should only be consumed after your doctor or physician deems you eligible for this medication. In case of diabetic neuropathy, even if your pain and discomfort doesn’t subside after taking a course of antidepressants or anti-seizure drugs for four weeks, it is recommended to speak to your doctor.

Who is not eligible for the treatment?

It is not recommended to avoid consuming anti-depressants or anti-seizure drugs if your nerve pain is not intense and is just mild. If you are looking forward for a romantic getaway, it is recommended to avoid these medicines as it causes loss of sex drive. People over 65 years, pregnant women and people who have bipolar disorder should reconsider taking anti-depressants and anti-seizure medications. It has also been seen that antidepressants can trigger suicidal tendencies in teens. Hence it is important to take a doctor’s advice before consuming these drugs.

Are there any side effects?

Antidepressants can be a boon to cure diabetic neuropathy but it may still have certain side effects such as nausea, weight gain, increase in appetite, erectile dysfunction, fatigue, insomnia, dry mouth, blurred vision, constipation, dizziness, agitation, irritability and anxiety. Even anti-seizure medicines can have certain side effects such as vomiting, nausea, dizziness, rash, vision changes, fatigue, loss of appetite and unsteady walking. Blurred vision and vertigo can also occur due to anti-seizure medications. Extremely rare side effects of consuming anti-seizure medications include liver or bone marrow failure. The use of this medication should be limited and prescribed by the physician only.

What are the post-treatment guidelines?

After you feel that the symptoms of diabetic neuropathy is subsiding due to medications, it is important to keep your body healthy and prevent the pain from becoming more intense. This can be done by using cold or hot patches, eating small meals frequently, avoiding fatty foods, wearing elastic compression stockings and exercising regularly. Massaging, stretching frequently and using a bed cradle to keep bedcovers away from your sensitive lower legs and feet can also help to prevent discomfort in the long run.

How long does it take to recover?

The symptoms of diabetic neuropathy can be relieved, but it cannot be cured completely. With exercise, physiotherapy and medication, the pain caused in the nerves due to diabetic neuropathy can be controlled to some extent.

What is the price of the treatment in India?

The price of the treatment in India varies according to the type of medication, physiotherapy required and the doctor’s fees.

Are the results of the treatment permanent?

The result of the treatment is not permanent as it depends solely on the patient’s capacity and body functions. Consuming the medicines only gives relief from pain but doesn’t cure diabetic neuropathy completely.

What are the alternatives to the treatment?

Other treatments include following certain exercises, physiotherapy, topical anesthetic cream and opioid analgesic medicines. Botox or Botulinum injections can also be used to cure abnormal sweating.

Popular Questions & Answers

I am 48 years and diabetic (h1abc-7.9) gone high in the last one year. Taking glycomet morning but still sugar not coming down. Walking for more than 30 mins start aching the legs. How do I control sugar level? Also I have tingling in tongue and dry throat. Even nasal passage including eyes and ear are mild pressure. Feeling some times the body is hot and legs go weak. Infection like symptoms. Please help.

Dip.Diab, Fellowship Diabetology (Gold Medallist), MBBS
Diabetologist, Thane
The pain in legs and tiredness can be a symptom due to high sugar. For maintaining. Good control your medicines need to be changed. However, if there any fever or cough cold pls check your covid antigen tested.

‌my name is 33 years old height is 147 cms and weight 143. 6 kgs since last november 2020 I got unbearable ankle pain and burning sensation hot flashes in both soles of feet unable to walk also still unable to tolerate as it's burning during night no sleep I am diabetic too fasting sugar 101 post sugar 163 please help me and here doctors saying to elevate legs high but am unable to due to heavy weight and legs I am getting breathlessness too please help me with diet and immediate relief for my problem my parents too suffering with me it's like acid burning since last year sleeping in chair only still now no bed present situation unable to walk taking help of my parents and on liquid fast as unable to go to washroom urination on chair due to that black red bed sores on backside dead skin hanging unable to stand or eat anything due to no or sweet taste in mouth please immediately help me with good diet but mostly immediate instant relief from heel pain left leg heel outer skin into white like no blood and came off right heel is too unbearable to touch red and hot unable to lift to apply any medicine please reply asap need instant relief please also used ultracet 30 tablets dolo kind plus 30 tablets gabapin etc please suggest instant pain reliever.

MS orthopaedic, MBBS, GDMO, Senior Resident, SR Doctor
Orthopedic Doctor, Jorhat
This looks to be associated with your diabetes. Probably diabetic neuropathy. Other less likely is radiculopathy. It needs to be evaluated clinically and with some tests if possible. Observed treatment and sugar control with early start of treatme...

I am 30 years old have diabetic fasting - 92 and ppbs- 150 taking glycomet 500 sr before breakfast which is better to take nurokind d3 or nurokind lc or nurokind plus.

MBBS, CCEBDM, Diploma in Diabetology, Diploma in Clinical Nutrition & Dietetics, Cetificate Course In Thyroid Disorders Management (CCMTD)
Endocrinologist, Dharwad
Hello, Thanks for the query. The glucose levels mentioned are quite well controlled. However, there is no mention of HbA1c%, which gives a clearer picture of long term blood glucose control. If you have no symptoms related to peripheral neuropathy...

I am diabetic and taking glycomet 500 sr once before breakfast and I felt anxiety and slow thinking then doc suggested nurokind plus I felt better n good but after 5 days I feel rashes in my body I stopped again I feel anxiety and nervousness please suggest is there any good multi vitamin?

MBBS, CCEBDM, Diploma in Diabetology, Diploma in Clinical Nutrition & Dietetics, Cetificate Course In Thyroid Disorders Management (CCMTD)
Endocrinologist, Dharwad
Hello, Thanks for the query. I have seen the query, in that there is no mention of your fasting, PP glucose levels and HbA1c%, which give an idea about how the diabetes is controlled. Because all the symptoms of associated with diabetes are based ...

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