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November 21, 2002

Complications

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Question from Galt, Missouri, USA:

I have type 2 diabetes, and the doctor as given me two months or I go on insulin shots, and I’m trying to get regulated, by go on Weight Watchers and walk 30 minutes per day, The problem is the bottom of my feet burn really badly, and feet and legs are also swelling. They burn so badly, the last thing I want to do is walk. Is there any thing I can do for it?

Answer:

This is a common description of diabetic neuropathy. There are several forms of treatment. First, improved blood sugar control is at the forefront of therapy. Improving your sugars will help with your symptoms. Second, you can use other medications until therapy is improved. If sleeping is a problem, the use of imipramine ( a form of antidepressant ) has been used successfully in patients with diabetic neuropathy. It also adds some hypnotic effect at night. In addition, we have used Neurontin (a medication previously used for seizures) successfully. Any of the medications can be used transiently. Most need several weeks to see benefit. Other topical treatments have been used, including capsaicin and TENS units. It is best to avoid use of narcotic analgesics because of their risk for dependency. Please check with your physician regarding the best choice for you.

JTL