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Nutrition is of utmost importance for individuals with diabetes because it is food that we eat that effects the changes in insulin that the pancreas may or may not produce in response.
In type II diabetes the goal is usually weight loss and weight management because of the insulin resistance (how the body can use the insulin effectively) and that requires a balanced nutrition plan to make sure not only the foods the person is eating is appropriate for their blood sugar, but also reducing the amount of fat and overall calorie intake because of the reduced load the body will then have to deal with.
Using the Canada’s Food Guide is the first step because most individuals over consume and consume foods inefficiently, the Canada’s Food Guide has portion sizes, food ideas that one may have no considered before, and the amount from each food  group one should get.
Additionally, if you know you have type II diabetes, it’s really important to contact a dietitian, specifically one that specializes in diabetes care.
Nutrition at this stage is probably the most important aspect of intervention because these individuals will have to take insulin for the rest of their lives and will require knowledge about how their blood sugars are affected by the foods they eat and how to prevent complications associated with extremely high or low blood sugars. The initial symptoms observed are reduced sensibility, burning sensation (occurring particularly at night and aggravating with contact) and tingling sensation in lower extremities  (pins-and-needles). The clinical examination should include full neurologic examination of sensory and motor functions and reflex evaluation.
Specific laboratory workup, as well as nerve conduction tests and electromyography can supplement the diagnostic control.
Further examinations should be conducted to rule out other causes of polyneuropathy in case the patient reports one of the following symptoms: acute onset, asymmetry of symptoms, great deal of pain, marked motor symptoms or rapid progression of motor symptoms.
Proper and effective treatment of diabetes mellitus with close blood glucose control, plays a major role in preventing and delaying the onset of symptoms in painful polyneuropathy. Comparative studies on pharmacotherapies for painful diabetic polyneuropathy have demonstrated that tricyclic antidepressants are the most effective drugs. In the dosage of 120 mg, the number needed to treat (NNT) for more than 50% pain improvement was 4,9 patients (NNT 4,9), whereas in the 60 mg dosage the number to treat for  more than 50% pain improvement was 5,2 patients (NNT 5,2).
If there is contraindication for Duloxetine (Cymbalta), the treatment should start with amitriptyline (Saroten).
Should the conservative treatment fail or serious intolerable adverse events occur from pharmacotherapy, Spinal Cord Stimulation (SCS) is indicated.


Research has shown that a small decrease in body weight can have large improvements in body blood sugar regulation which is why treating diabetes type II with weight loss and addressing it fast are important for later complications.
This is due to pancreas cells being genetically defective or, as it is becoming more pronounced later in life, can be attributed to insulin resistance that is emphasized by unhealthy lifestyle options as well environmental agents. There are approximately 250 million people worldwide suffering from diabetes mellitus and 20-30 million of them suffer from neuropathy. Nerve impairment is accompanied by microvascular dysfunction that affects the nerve vascular network. Painful diabetic polyneuropathy has to be differentiated from other types of polyneuropathy with the use of specific tests. Once symptoms begin, they rarely subside on their own and there is need for specific pharmacotherapy to cope with the neuropathic pain.
However, their administration in high and effective doses is limited due to adverse events often occurring. Treatment with gabapentin (Neurontin) has shown only small differences compared to amitryptiline (antidepressant). As long as the patient reports more than 50% pain relief during the trial period, the final implantation of the neurostimulation system is performed. Please always consult your doctor before taking any advice learned here or on any other website. If you cannot go to a dietitian or specialist for any reason, below are two sites you can visit by clicking on them. Diabetic polyneuropathy is closely correlated with the diabetic chronicity and blood glucose control. This is due to oxidation, which is caused by hyperglycaemia and other disorders of homeostasis and metabolism. Symptoms may be accompanied by trophic changes and poor wound healing due to microangiopathy.


The differential diagnosis from polyneuropathy of toxic aetiology is of particular high importance because it is a reversible condition.
According to the results of three studies, 45-55% of patients who received duloxetine reported more than 50% improvement in pain intensity compared to the comparator drug.
In the Pregabalin (Lyrica) group, 39-46% of patients reported over 50% pain improvement with the dosage from 300 to 600 mg. There are 4 studies showing satisfactory results for SCS in painful diabetic polyneuropathy and the method is recommended in case the conservative treatment fails. The extra insulin allows the glucose to be taken up by the liver and other tissues, so cells get the glucose they need and blood-sugar levels stay normal. They have resources that you could use as well as a way to contact other health care professionals related to diabetes management. Close blood glucose control determines the prevention of painful diabetic polyneuropathy to a significant extent. Duloxetine (Cymbalta), pregabalin (Lyrica) and gabapentin (Neurontin) seem to have similar efficacy in painful diabetic polyneuropathy. While you will be able to view the content of this page in your current browser, you will not be able to get the full visual experience. Please consider upgrading your browser software or enabling style sheets (CSS) if you are able to do so.



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