Diabetic neuropathy: questions when starting a medication

Diabetic neuropathy is a type of nerve damage that occurs in people who have diabetes. The most common form of diabetic neuropathy is diabetic peripheral neuropathy. It’s estimated that half of people who have diabetes experience peripheral diabetic neuropathy at some point, and regular screening should be a part of every diabetes management plan.

Diabetic peripheral neuropathy most often affects the feet and legs (though it can also affect the hands and arms). Pain and numbness are common symptoms. Pain can be shooting, burning, tingling, and extreme sensitivity to touch—symptoms that can significantly impact a person’s quality of life, including things like work, sleep, and mental health.

Numbness and weakness can affect balance, putting a person at risk for falls and injuries. It can also cause a person to be unaware of injuries to the feet, such as ulcers (wounds that do not heal and can become infected). Diabetic neuropathy can also lead to amputations.

Treatment for diabetic neuropathy

Treatment for diabetic neuropathy focuses on diabetes control, alleviating symptoms, and preventing complications. Treatment will vary from person to person, depending on the symptoms they are experiencing, the areas of the body that are affected, and many other factors. Medications are often a part of treatment. These can include:

• Changes to the medications a person is taking to manage diabetes, such as changing the dose, adding a medication, or switching medications
• Medications to control cholesterol levels and blood pressure
• Medications to help with weight loss
• Medications for pain (such as pain relievers, antiseizure medications, or certain types of antidepressants)
• Transdermal patches (patches that stick to the skin and release medicine) or other topical treatments for pain caused by peripheral diabetic neuropathy in the feet and/or legs
• Medications for other complications caused by diabetic neuropathy, such as therapies to help with bladder control, sexual function, or GI symptoms

Questions when starting a new medication

People with diabetes and diabetic neuropathy often take multiple medications. It’s important to understand what medications you are taking, how these medications work, the goal of taking each medication, and how to take each medication.

Here are some questions to ask your healthcare provider:

• What is the name of the medication?
• What dosage will I be taking?
• Why do you recommend this medication for me?
• How is this medication administered?  How often will I need to take this medication and at what times of day?
• What is the goal of taking this medication? How will we know if this medication is working?
• What can I do to get the most benefit from this medication?
• Is there anything that I need to avoid while taking this medication? Can this medication interact with other medications?
• What is the risk of side effects? Is there any risk of severe side effects? What symptoms do I need to watch for? How can side effects be avoided and/or addressed?
• What will this medication cost? Ask what you can do and who you can talk to if you have concerns about the cost of a medication?

It’s a good idea to review your family medical history, personal medical history, and the full prescribing information, and bring up any concerns with your healthcare provider. Your healthcare provider should also have an up-to-date list of medications you are taking, including prescription medications, over-the-counter medications, and supplements (including herbal supplements).