Managing diabetic neuropathy complications
Diabetic neuropathy — a type of nerve damage that can occur over time due to high blood sugar in those who have diabetes — is a common, serious complication of diabetes. In addition to the pain that diabetic neuropathy can cause, it can also lead to other complications, such as problems with your digestive system, urinary tract, blood vessels and heart.
Specific treatments exist for many of the complications of diabetic neuropathy, including:
- Urinary tract problems. Antispasmodic medications (anticholinergics), behavioral techniques such as timed urination, and devices such as pessaries — rings inserted into the vagina to prevent urine leakage — may be helpful in treating loss of bladder control. A combination of therapies may be most effective.
- Digestive problems. Gastroparesis — a condition in which the stomach empties too slowly or not at all — can usually be helped by eating smaller, more-frequent meals, reducing fiber and fat in the diet, and, for many people, eating soups and pureed foods. Diarrhea, constipation and nausea may be helped with dietary changes, probiotics and medications.
- Low blood pressure on standing (orthostatic hypotension). This is often helped with simple lifestyle measures, such as avoiding alcohol, drinking plenty of water and standing up slowly. Your doctor may recommend an abdominal binder, a compression support for your abdomen, and compression stockings. Several medications, either alone or together, also may be used to treat orthostatic hypotension.
- Sexual dysfunction. Sildenafil (Revatio,Viagra), tadalafil (Adcirca, Cialis) and vardenafil (Levitra, Staxyn) can improve sexual function in some men, but these medications aren't effective or safe for everyone. When medications don't work, many men turn to vacuum devices, or, if these fail, to penile implants. Women may be helped with vaginal lubricants.
For some people, these symptoms are mild; for others, diabetic neuropathy can be painful, disabling and even fatal. Work with your doctor to determine the best approach to managing your diabetic neuropathy complications.
May 07, 2014
- Diabetic neuropathies: The nerve damage of diabetes. National Institute of Diabetes and Digestive and Kidney Diseases. http://diabetes.niddk.nih.gov/dm/pubs/neuropathies/neuropathies.pdf. Accessed Nov. 10, 2011.
- Standards of medical care in diabetes, 2011. American Diabetes Association. Diabetes Care. 2011;34(suppl):11.
- Diabetic neuropathies. American Diabetes Association. Diabetes Care. 2005;28:956.