Diabetic neuropathy: Current treatment options & clinical research

Diabetic neuropathy—or nerve damage—is a common and serious complication of diabetes. Often referred to as peripheral neuropathy, the condition can cause numbness, tingling, and pain throughout the body, but is most often found in the hands and feet.

Though there is currently no cure for diabetic neuropathy, treatments do exist, and more are being studied in active clinical trials. These options can help mitigate symptoms and improve the quality of life for those living with neuropathy.

What can happen if diabetic neuropathy goes untreated?

If you have been diagnosed with diabetic neuropathy, it is critical that you seek treatment immediately, as the condition can have serious or even fatal consequences if left untreated. This is often due to infections. Loss of feeling in the feet can make it difficult to notice and properly care for minor cuts and blisters. Because diabetes can cause poor circulation, these injuries are difficult to heal, more likely to become infected, and an increased risk for gangrene. As a result, between 1-2% of all diabetic patients undergo lower limb amputation.

Untreated diabetic neuropathy can also cause other health problems. Damage to the nerves controlling the cardiovascular system can cause exercise intolerance and fainting episodes due to drops in blood pressure and/or the inability to appropriately increase heart rate. Cardiovascular nerve damage is also associated with an increased risk for stroke, death after a heart attack, and leads to a significant decrease in lifespan.

How is diabetic neuropathy currently treated?

Nerve damage cannot be reversed once it has occurred. As such, the most important aspect of neuropathy treatment is to prevent the worsening of the condition by addressing known risk factors. Proper glucose management and a focus on nutrition, exercise, and weight loss are key. Performing HbA1c testing, which reflects blood glucose levels over a two-to-three month period of time, is important in monitoring whether these efforts are working.

Cholesterol and triglyceride levels should also be checked regularly to ensure that they remain within normal levels. Cholesterol lowering medications may be recommended if dietary changes alone are not enough to help you stay within a healthy range. If you smoke, your provider will strongly encourage you to quit. Certain medications and behavioral interventions can be provided to help in this effort.

Depending upon the severity of the neuropathy symptoms, medication may be required to improve your overall functioning and quality of life. Some neuropathy symptoms that commonly require medical treatment include:

• Pain: There are several prescription medications that have shown to be helpful in the treatment of diabetic neuropathy pain including pregabalin, gabapentin, and duloxetine. Additionally, several older antidepressant medications (amitriptyline, nortriptyline) have been used for decades in the treatment of a variety of pain conditions including diabetic neuropathy.However, medication is not your only option. Behavioral therapy and complementary treatments, such as acupuncture, meditation, and massage have been used with success by many patients. Newer treatments continually emerge, such as the recent development of implantable electrical nerve stimulation treatments.

• Delayed gastric emptying: If you experience nausea, vomiting, bloating, or loss of appetite, medications such as metoclopramide, erythromycin, and domperidone can help by stimulating gastric muscles. Diphenhydramine (Benadryl®), ondansetron (Zofran®), and prochlorperazine (Compazine®) are often used to reduce nausea. In severe cases, electrical stimulation devices can also be used to promote stomach emptying.

• Low blood pressure: Compression stockings are often used to counter low blood pressure. However, when this measure alone is not enough, medications such as fludrocortisone, midodrine, and droxidopa can be used.

MedVadis Research diabetic neuropathy trials  

Despite existing treatments, many people with diabetic neuropathy continue to experience significant pain and suffering. Clinical research is a critical component of identifying and developing the next generation of treatments to help these patients.

For more than 30 years, MedVadis has been committed to furthering these research efforts.  Our research staff has contributed to the development of several current diabetic neuropathy treatments including, high-frequency neurostimulation (Senza HFX®), gabapentin (Neurontin®, Gralise®), and pregabalin (Lyrica®). Today,MedVadisremains committed to the development of the next generation of non-opioid-based treatments that are safer, more effective, and carry fewer side effects.

The research required to achieve our goals depends upon the thousands of volunteers who participate in diabetic neuropathy trials throughout the world each year. Study volunteers are critical to the evaluation of new treatments, and their efforts help improve the lives of other diabetic neuropathy sufferers.

Peripheral diabetic neuropathystudy volunteersacquire access to cutting-edge treatments that would otherwise be unavailable, undergo comprehensive physical and neurological examinations, and are connected to a medical team that closely monitors their health. Study volunteers also undergo extensive laboratory testing, including liver and kidney function, electrolyte levels, diabetic profile testing, cholesterol testing, and hematological testing for anemia and bleeding disorders.

Diabetic neuropathy research trialsrange from a few weeks to several months in length, with the majority of visits occurring no more frequently than every two-to-four weeks. While both the medication being studied and the manner in which it is taken varies by study, the majority of our trials involve the use of oral medications. None of our trials involve the use of opioid medications.

To learn more about our current diabetic research studies and how you can contribute, please visit us atwww.MedVadis.com