Neuropathy & Pain

David Levy, MD, FRCP      Erectile dysfunction This is the commonest neuropathic complication: 20% of men have erectile dysfunction (ED) at diagnosis, increasing to 34% at 12 years (UKPDS). The prevalence in a newly diagnosed Kuwaiti population was 30%, and nearly 50% in a large survey of Canadians attending their primary-care physicians ...

David Levy, MD, FRCP      Mononeuropathies and other focal syndromes Peripheral mononeuropathies Upper limb Carpal tunnel syndrome (median nerve) Carpal tunnel syndrome is very common (remember the association with primary hypothyroidism, especially in type 1 diabetes) and may present with atypical symptoms, as it is often superimposed on diabetic polyneuropathy. Consider it ...

David Levy, MD, FRCP      Charcot neuroarthropathy Charcot neuroarthropathy is a serious and poorly understood condition associated with rapid destruction of bones and joints and resulting in bone fragmentation. It occurs only in patients with advanced sensory and autonomic neuropathy, and is characteristic of long-duration type 1 diabetes with other microvascular complications, ...

David Levy, MD, FRCP      Foot ulceration The ulcerated, infected and possibly gangrenous foot is a common reason for hospital admission. Anatomically, diabetic foot ulceration is restricted to the region distal to the ankle; proximal lesions are more likely ischemic, vasculitic, venous, or to have another underlying cause. Most ulcers are predominantly ...

David Levy, MD, FRCP      Introduction The devastating consequences of diabetic neuropathy are seen every day both in hospital – more bed days are taken up with the consequences of diabetic foot ulceration than any other diabetic complication – and in primary care, where sensory symptoms, especially pain, and autonomic neuropathy, especially ...

Low fat, low GI diet results in lost weight, some reduction in diabetic nerve pain… Encouraging lifestyle and dietary modifications is a standard protocol for physicians and educators working with type 2 diabetic patients in an effort to reduce diabetes-related complications. In a small pilot study researchers investigated whether or ...

Components of metabolic syndrome associated with peripheral neuropathy in prediabetic patients…

Omega-3 fatty acids in found to improved nerve damage in mice with type 1 and type 2… Approximately 50 percent of patients with diabetes suffer from nerve damage, or neuropathy. No cure exists, and the most effective treatment, keeping blood sugar in control, only slows neuropathy. But a new study ...

Metformin + H2RA and/or PPI = a recipe for neuropathy… An increased BMI is commonly seen in patients with T2D and/or GERD. Metformin is often the first line of therapy for patients with T2D, while H2RA and PPIs are commonly prescribed for patients with GERD. All three agents have been ...

Some positive effects seen but no decrease in pain intensity was observed…. A common complication of diabetes is painful diabetic peripheral neuropathy (P-DPN). Current standard of care for patients with P-DPN involves pharmacological interventions that are limited by their potential adverse side effects. Numerous drugs are still being developed and ...