My insulin Log

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1. 
   Arnon J

   Once you have nerve damage it never gets better. I guess after a while maybe you learn to live with the discomfort and it’s less noticable?
   I guess I’m lucky I have been type 1 for 45 years and have no damage at all. I do understand what you are going through as a good friend of mine is type 2. She never took it seriously because she was not on insulin. Now she is on insulin and has little use of her right hand and lower leg and is always in pain.

   January 28, 2010 9:15 am | #1
2. 
   Mr. P's Person

   The nerve damage is permanent. The is why it is so very very important to keep a blood sugar as well controlled as possible as the damage done by diabetes is generally permanent.

   January 28, 2010 9:27 am | #2
3. 
   mlgable

   it may last a lifetime, there is a new med out for it

   January 28, 2010 9:47 am | #3
4. 
   Jane Doe

   once you have it, it’s not going to go away….but if your diabetes is controlled you are likely to find relief

   January 28, 2010 10:15 am | #4
5. 
   Blanca C

   how old are you and how controlled is your blood sugar? You might have the neuropathy forever.

   January 28, 2010 11:06 am | #5
6. 
   mysticdu

   you can do leg excercises to try to build your muscles back up some but the condition is permanent.all the pain doesn’t go away i have had it for 4 years i’ve tried the physical therapy and i’ve lost 57lbs it didn’t make much difference
   i now excercise my legs daily for about 15 minutes and i take neurontin it’s was originally used for depression but does ease some of the pain of neuropathy and my legs feel stronger than before i’ve been doing this for about 6mo.s now

   January 28, 2010 11:33 am | #6
7. 
   Charlotte L

   My friend Wayne’s feet were actually turning purple because of his Diabete’s and now they are a healthy pink. He used some magnetic insoles and they eventually stopped the pain as well. Check out all the info from this website, especially the video from the Discovery channel at the bottom. For the price of a nice dinner out, they’re worth it.
   http://www.yourwellnesshome.net

   January 28, 2010 12:32 pm | #7
8. 
   job_bust

   shouldn’t you be asking your Dr’s these questions…you already know about the diabete’s, then they should have told you about the rest, if not, you should have asked..it’s their job.

   January 28, 2010 12:52 pm | #8
9. 
   Chrys

   I am very sorry, but once you have nerve damage it is not reversible. However there is two medications that I am aware of that help with the pain. Neurontin or Lycra (sp) Talk with your Dr. about this. I hope you have an endorinelogist who specializes in diabetes. How is the insulin pump working for you?

   January 28, 2010 1:38 pm | #9
10. 
    Patty T

    Diabetic neuropathies are neuropathic disorders that are associated with diabetes mellitus. These conditions are thought to result from diabetic microvascular injury involving small blood vessels that supply nerves (vasa nervorum). Relatively common conditions which may be associated with diabetic neuropathy include third nerve palsy; mononeuropathy; mononeuropathy multiplex; diabetic amyotrophy; a painful polyneuropathy; autonomic neuropathy; and thoracoabdominal neuropathy
    Diabetes is the leading known* cause of neuropathy in developed countries, and neuropathy is the most common complication and greatest source of morbidity and mortality in diabetes patients. It is estimated that the prevalence of neuropathy in diabetes patients is approximately 20%. Diabetic neuropathy is implicated in 50-75% of nontraumatic amputations.
    The main risk factor for diabetic neuropathy is hyperglycemia. In the DCCT (Diabetes Control and Complications Trial, 1995) study, the annual incidence of neuropathy was 2% per year, but dropped to 0.56% with intensive treatment of Type 1 diabetics. The progression of neuropathy is dependent on the degree of glycemic control in both Type 1 and Type 2 diabetes. Duration of diabetes, age, cigarette smoking, hypertension, height and hyperlipidemia are also risk factors for diabetic neuropathy.
    The largest group of neuropathy patients are of unknown cause, referred to as “idiopathic” origin. Of the roughly 100 known causes, diabetes is by far the largest. Other known causes include genetic factors, damaging chemical agents such as chemotherapy drugs, and HIV.
    Diabetic neuropathy affects all peripheral nerves: pain fibers, motor neurons, autonomic nerves. It therefore necessarily can affect all organs and systems since all are innervated. There are several distinct syndromes based on the organ systems and members affected, but these are by no means exclusive. A patient can have sensorimotor and autonomic neuropathy or any other combination. Symptoms vary depending on the nerve(s) affected and may include symptoms other than those listed. Symptoms usually develop gradually over years.
    Usual symptoms may be:
    Numbness and tingling of extremities
    Dysesthesia (decreased or loss of sensation to a body part)
    Diarrhea
    Constipation
    Urinary incontinence (loss of bladder control)
    Impotence
    Facial, mouth and eyelid drooping
    Vision changes
    Dizziness
    Muscle weakness
    Dysphagia (swallowing difficulty)
    Speech impairment
    Fasciculation (muscle contractions)
    Treatment of early manifestations of sensorimotor polyneuropathy involves improving glycemic control. Tight control of blood glucose can reverse the changes of diabetic neuropathy, but only if the neuropathy and diabetes is recent in onset. Conversely, painful symptoms of neuropathy in uncontrolled diabetics tend to subside as the disease and numbness progress. Of course, these uncontrolled patients are at great risk for diabetic foot ulcers and amputation because of neuropathy.
    Despite advances in the understanding of the metabolic causes of neuropathy, treatments aimed at interrupting these pathological processes have been limited by side effects and lack of efficacy. Thus, treatments are symptomatic and do not address the underlying problems. Agents for pain caused by sensorimotor neuropathy include tricyclic antidepressants (TCAs), serotonin reuptake inhibitors (SSRIs) and antiepileptic drugs (AEDs). None of these agents reverse the pathological processes leading to diabetic neuropathy and none alter the relentless course of the illness; again, they just treat the pain.
    TCAs include imipramine, amitriptyline, desipramine and nortriptyline. These drugs are effective at decreasing painful symptoms but suffer from multiple side effects that are dosage dependent. One notable side effect is cardiac toxicity, which can lead to fatal arrhythmias. At low dosages used for neuropathy, toxicity is rare, but if symptoms warrant higher doses, complications are more common. Among the TCAs, amitriptyline is most widely used for this condition, but desipramine and nortriptyline have fewer side effects.
    SSRIs include fluoxetine, paroxetine, sertraline and citalopram. They are less effective that TCAs in relieving pain, but are better tolerated. Side effects are rarely serious, and do not cause any permanent disabilities. They cause sedation and weight gain, which can worsen a diabetic’s glycemic control. They can be used at dosages that also relieve the symptoms of depression, a common concommitent of diabetic neuropathy.
    The SSNRI duloxetine (Cymbalta) is approved for diabetic neuropathy. By targeting both serotonin and norepinephrine, it targets the painful symptoms of diabetic neuropathy, and also treats depression if it exists. Typical dosages are between 60mg and 120mg.
    AEDs, especially gabapentin and the related pregabalin, are emerging as first line treatment for painful neuropathy. Gabapentin compares favorably with amitriptyline in terms of efficacy, and is clearly safer. Its main side effect is sedation, which does not diminish over time and may in fact worsen. It needs to be taken three times a day, and it sometimes causes weight gain, which can worsen glycemic control in diabetics. Carbamazepine (Tegretol®) is effective but not necessarily safe for diabetic neuropathy. Its first metabolite, oxcarbazepine, is both safe and effective in other neuropathic disorders, but has not been studied in diabetic neuropathy. Topiramate has not been studied in diabetic neuropathy, but has the beneficial side effect of causing mild anorexia and weight loss, and is anecdotally beneficial.
    Methylcobalamin, a special form of Vitamin B12, is being studied now for treatment of neuropathy, both injected and oral. Initial studies[1] and anecdotal evidence in cats[2] have been very encouraging.[3].
    In addition to pharmacological treatment there are several other modalities that help some cases. While lacking double blind trials, these have shown to reduce pain and improve patient quality of life particularly for chronic neuropathic pain: Interferential Stimulation; Acupuncture; Meditation; Cognitive Therapy; and prescribed exercise. In more recent years, Photo Energy Therapy devices are becoming more widely used to treat neuropathic symptoms. Photo Energy Therapy devices emit near infrared light typically at a wavelength of 890nm. This wavelength is is believed to stimulate the release of Nitric Oxide, an Endothelium-derived relaxing factor into the bloodstream, thus vasodilating the capilaries and venuoles in the microcirculatory system. This increase in circulation has been shown effective in various clinical studies to decrease pain and improve sensation in diabetic and non-diabetic patients. Photo Energy Therapy devices seem to address the underlying problem of neuropathies, poor microcirculation, which leads to pain and numbness in the extremities4, 5.
    While it is quite true that recognized treatment modalities backed up by double blind trials do not address the underlying causality of diabetic neuropathy, two other programs have had substantial although still anecdotal results. The first involves a program of nutritional supplements put forth in an Internet article researched and published by diabetic neuropathy patients themselves (although heavily referencing peer-reviewed research articles). This article is entitled “A Multidisciplinary Approach to Diabetic Neuropathy Treatment” and its treatment regimen has been instrumental in substantial reversal in individuals throughout the world. See http://www.geocities.com/bsy53/dn/neurop…
    The second method involves a combination of a vegan diet combined with moderate walking exercise. It has been used over several decades to affect both Type II diabetes as well as diabetic peripheral neuropathy.
    The mechanisms of diabetic neuropathy are poorly understood. At present, treatment alleviates pain and can control some associated symptoms, but the process is generally progressive.
    As a complication, there is an increased risk of injury to the feet because of loss of sensation (see diabetic foot). Small infections can progress to ulceration (skin and soft tissue breakdown) and this may require amputation. In addition, motor nerve damage can lead to muscle breakdown and imbalance.

    January 28, 2010 2:05 pm | #10