Treatment of diabetic neuropathy: Drugs to relieve the discomfort...

Unfortunately, there is no specific cure for diabetic neuropathy. Therapy is symptomatic, preventive. It alleviates existing problems and improves the patient's well-being.

The goals of treatment are as follows:

• Slowing the progression of the disease and the worsening of symptoms
• relieve pain
• restoring proper organ function and preventing complications

Slowing the progression of the disease

The most important factor in preventing further nerve damage is careful control of blood sugar levels, i.e. glycaemia.

Fasting glycaemia is the blood sugar level at least eight hours after the last meal. The ideal value is between 3.3 and 5.6 mmol/l.

Random glycaemia is a value that is measured during the day regardless of food intake, e.g. 2 hours after the last meal. This is only a guideline value but ideally should not exceed 7.8 mmol/l.

Other important ways to slow or prevent the deterioration of neuropathy include keeping blood pressure under control, maintaining a healthy weight and regular physical activity.

Relieving pain

Therapy for neuropathic pain in the painful form of diabetic neuropathy is still not satisfactory. Only about half of patients experience pain relief.

The key is to individualise treatment. Not every patient is suitable for the same therapy.

Anticonvulsants, which are also used in the treatment of seizure disorders, are the drugs of first choice. The most commonly used drugs with good effect are gabapentin and pregabalin. Common side effects include drowsiness, dizziness and swelling.

Antidepressants such as amitriptyline, duloxetine etc. are also used. Side effects are quite common. They include dry mouth, drowsiness, decreased appetite and constipation.

Opioids are considered second choice drugs if the condition does not improve. Great caution is needed when taking them as these drugs quickly become addictive.