ANNOUNCER: The first step in delaying the progression of peripheral neuropathy is to control the patient's diabetes. The patient and the healthcare provider can work together to decide the best way to control blood sugar levels.
ROY FREEMAN, MD: Since the nerve damage is a direct consequence of the elevated blood glucose, it's vital that blood glucose be tightly monitored. Patients should control their diet carefully, exercise and also, under medical supervision, appropriately use prescribed medications, both oral medications and insulin, if necessary.
RUSSELL K. PORTENOY, MD: Patients with painful diabetic polyneuropathy have to have frequent measurements of their blood glucose, and also measurement of their hemoglobin A1C. Hemoglobin A1C is an indicator in the blood of how well the person's glycemic control, meaning to say how well their diabetes has been controlled, during the past period of time measured in weeks.
Most people would say that the hemoglobin A1C should be below 7 percent, and that if it goes above 7 or 7.5 percent, then the person needs much more aggressive management.
ANNOUNCER: In addition to controlling the patient's diabetes, there are many options for controlling the most debilitating symptom of DPN: pain.
ASTRID ALMODOVAR, MD: The pain of diabetic neuropathy can impact a patient's life in a very, very negative way. It is a pain sometimes that does not go away. It is something that inhibits or interferes with their ability to sleep, and therefore it's going to go on to cause fatigue, irritability during the day.