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Pain Medication And Diabetes

Tips For Treating Diabetic Nerve Pain

Tips For Treating Diabetic Nerve Pain

Diabetes can cause long-term problems throughout your body, especially if you don’t control your blood sugar effectively, and sugar levels remain high for many years. High blood sugar can cause diabetic neuropathy, which damages the nerves that send signals from your hands and feet. Diabetic neuropathy can cause numbness or tingling in your fingers, toes, hands, and feet. Another symptom is a burning, sharp, or aching pain (diabetic nerve pain). The pain may be mild at first, but it can get worse over time and spread up your legs or arms. Walking can be painful, and even the softest touch can feel unbearable. Up to 50 percent of people with diabetes may experience nerve pain. Nerve damage can affect your ability to sleep, decrease your quality of life, and can also cause depression. Damaged nerves can’t be replaced. However, there are ways that you can prevent further damage and relieve your pain. First, control your blood sugar so the damage doesn’t progress. Talk to your doctor about setting your blood sugar goal, and learn to monitor it. You may be asked to lower your blood sugar before meals to 70 to 130 milligrams per deciliter (mg/dL) and your blood sugar after meals to less than 180 mg/dL. Use diets, exercise, and medications to decrease your blood sugar to a healthier range. Monitor other health risks that can worsen your diabetes, such as your weight and smoking. Ask your doctor about effective ways to lose weight or quit smoking, if necessary. Your doctor might suggest trying an over-the-counter pain reliever, such as acetaminophen (Tylenol), aspirin (Bufferin), or ibuprofen (Motrin IB, Advil), which are available without a prescription but can cause side effects. Use a low dose for a short time to control your symptoms. Other options exist for stronger Continue reading >>

How To Manage Diabetes While On Oxycodone

How To Manage Diabetes While On Oxycodone

What happens to a person’s blood sugar when they are under stress due to pain, and must take a narcotic pain reliever such as oxycodone? In this article, we will explore what happens to a person with diabetes who is taking long term pain medication. We will look at whether it raises or lowers blood glucose. We will look at how taking oxycodone affects blood glucose levels, activity levels and appetite, and how that could influence the self-management of diabetes. We will look at ways that you can maintain blood glucose in target ranges while taking a narcotic pain reliever such as oxycodone. John’s story As John relayed to me during a phone conversation, he is taking a combination of oxycodone plus acetaminophen for severe pain in his legs related to poor circulation and neuropathy because of his Type 1 diabetes. He has had severe sleep disruption, and was getting no relief on nonsteroidal anti-inflammatory agents. He has been taking oxycodone now for about three months, and has seen a need to increase the basal rate on his insulin pump in order to stay in target range with his blood glucose. He found that once the stress of the pain was gone, his numbers have stayed in range. I suggest reading the following: What is oxycodone? Oxycodone is a narcotic pain reliever that is used to relieve moderate to severe pain. It is in the class of drugs called “opiate analgesics,” and can be found in combination with other nonsteroidal anti-inflammatory medications such as aspirin, acetaminophen, or ibuprofen. Oxycodone can also be found in combination with aspirin and acetaminophen. Each of these components can also have side effects in addition to the oxycodone. Brand names of combination medications include Nortab, Vicodin, and Lortab and Percocet. Precautions for oxycodo Continue reading >>

Diabetes And Sick Days: What Meds Are Ok

Diabetes And Sick Days: What Meds Are Ok

In the midst of cold and flu season, you may wonder what medications are safe to take without greatly impacting blood glucose levels when you have diabetes. Overall, it's the sickness that increases blood glucose in people with diabetes, not the medication used to treat it. However, some medications should be used with caution. Stacey O'Donnell, R.N., B.S., C.D.E., nurse manager, at Joslin Diabetes Center, goes over different types of medications and how they could impact your diabetes. Examples: Tylenol, Aspirin Effect on diabetes: No effect. Use cautiously if you have renal disease. Anti-inflammatory Examples: Ibuprofen, such as Advil, Motrin, Nuprin Effect on diabetes: No effect. Also should be used carefully if you have renal disease. Examples: Allegra, Bumex Effect on diabetes: Caution should be used in patients who have diabetes with renal disease, cardiac disease and high blood pressure. General guidelines for taking medications for people with diabetes are to avoid products containing sugar, such as sucrose, dextrose, fructose, lactose and honey, O'Donnell says. Also, choose products with little or no alcohol. A suggested list of sugar-free cough and cold medicines includes: Chlor-Trometon tablets Dimetapp Elixir Scot-Tussin DM Liquid Cerose-DM Liquid Continue reading >>

Diabetes Medications: People Skipping Treatments To Save Money

Diabetes Medications: People Skipping Treatments To Save Money

According to the CDC, 29 million Americans have type 1 or type 2 diabetes, up from 26 million in 2010. Type 2 diabetes accounts for 95 percent of all cases. Diabetes is a chronic disease, so the really bad things that are associated with diabetes tend not to happen immediately, but are five years or 10 years down the road, said Evan Sission, PharmD, certified diabetes educator, and spokesperson for the American Association of Diabetes Educators (AADE) . Diabetes is a syndrome of several different diseases. Patients often have high blood pressure, elevated cholesterol levels, and kidney disease. All these things are running concurrently, Sisson told Healthline. So, if they skip their medication for cholesterol, lets say, they may not feel any effects at all. In fact, they may actually feel better if they had been experiencing side effects from the necessary medication. The lack of immediate consequences from skipping pills is a common reason people do not stick to medication. Diabetes isnt like chronic pain, where if a patient misses their pain medication, they immediately think I need to take my pain medication. Patients with diabetes dont necessarily feel the effects, Sisson said. The long-term consequences of not controlling diabetes are severe. Sission says that clinical trial data shows that it puts patients at increased risk of blindness and kidney damage, which would require dialysis, and nerve damage. Further down the road, it puts them at risk of heart disease as well, Sisson says. Nerve damage can lead to some major problems. It often results in a similar type of feeling that someone gets temporarily when their foot falls asleep if theyve cut off circulation. People with diabetes whose feet are always asleep may not notice when theyve hurt themselves. The cut Continue reading >>

Effects Of Opioids On Diabetes

Effects Of Opioids On Diabetes

Watch This Report On The Relationship Between Opioids And Diabetes People with diabetes are often plagued by acute and chronic pain. According to an article in the Journal of General Internal Medicine, four out of ten adults with Type 2 diabetes suffer from pain. Whether because of diabetic neuropathy, osteoarthritis, or from the effects of obesity, patients often turn to opioids for pain relief. While opioid medications may provide some measure of relief, they’re also associated with significant health risks, including weight gain and glycemic dysregulation. When it comes to behavioral problems, the use of opioids can have an immediate effect on your ability to monitor and control your diabetes. The altered perceptions of pain that make opioid medications work can also affect the monitoring of your own diabetes conditions. In an altered state, it can become difficult to recognize hypoglycaemia, hyperglycaemia, or diabetic ketoacidosis. These altered perceptions themselves can also impact a normal health routine. When not in the right mind, it increases the risk of missing insulin injections that can then lead to hypoglycaemia, hyperglycaemia, or diabetic ketoacidosis. In addition, these altered perceptions from opioid use can influence your own healthy eating habits, making it more difficult to control your blood glucose levels and the ability to manage your diabetes. In a study published in the Journal of Opioid Management, researchers found that certain types of opioids may even induce a taste preference for sweet foods. This preference and acting upon it can, of course, lead to issues with diabetes control and management. It can also lead to weight gain and tooth decay. If you are on opioids for pain, discuss alternative forms of treatment with your doctor. While Continue reading >>

Choosing A Pain Reliever

Choosing A Pain Reliever

Choosing Wisely is an initiative by the ABIM Foundation to identify commonly-used tests or procedures whose necessity should be questioned and discussed. This information was developed by Consumer Reports in cooperation with the American Society of Nephrology. If you need a painkiller but suffer from high blood pressure, heart failure, or kidney disease, it’s best to steer clear of some commonly used pain relievers. Those include: Ibuprofen, which is sold under the brand names Advil and Motrin, and also as a generic or store brand. You can buy it without a prescription at the drug store. It’s sometimes combined with other drugs in other over-the-counter products, such as certain cold remedies. Naproxen, sold under the brand name Aleve and as a generic or store brand. It doesn’t need a prescription, either. Celecoxib, a prescription drug sold as Celebrex. All three of those drugs, which are called nonsteroidal anti-inflammatory drugs, or NSAIDs, can ease pain and inflammation. But they are too risky if you have any of those health problems. Here’s why. They’re bad for high blood pressure. All NSAIDs can cause or worsen high blood pressure. That increases your chance of having a heart attack or stroke. The drugs can also make some blood pressure drugs less effective. That includes diuretics such as hydrochlorothiazide (Hydrodiuril and generic), ACE inhibitors such as lisinopril (Prinivil, Zestril, and generic) and ARBs such as losartan (Cozaar and generic). They’re bad for the heart and kidneys. Long-term use of NSAIDs can make your body hold onto fluid, which can worsen heart failure symptoms, such as shortness of breath, swollen ankles, and a rapid or irregular heartbeat. They can also reduce kidney function. That makes the drugs risky for people who already Continue reading >>

Identifying And Treating Diabetes Joint Pain

Identifying And Treating Diabetes Joint Pain

Diabetes and joint pain are considered to be independent conditions. Joint pain may be a response to an illness, injury, or arthritis. It can be chronic (long-term) or acute (short-term). Diabetes is caused by the body not using the hormone insulin correctly, or insufficient production of it, which affects blood sugar levels. What would a hormone and blood sugar-related condition have to do with joint health? Diabetes is associated with widespread symptoms and complications. According to the Centers for Disease Control and Prevention, 47 percent of people with arthritis also have diabetes. There is an undeniably strong link between the two conditions. Diabetes can damage joints, a condition called diabetic arthropathy. Unlike pain caused by immediate trauma, the pain of arthropathy happens over time. Other symptoms include: thick skin changes in the feet painful shoulders carpal tunnel syndrome A joint is the place where two bones come together. Once a joint wears down, the protection it provides is lost. Joint pain from diabetic arthropathy comes in different forms. Charcot’s joint occurs when diabetic nerve damage causes a joint to break down. Also called neuropathic arthropathy, this condition is seen in the feet and ankles in people with diabetes. Nerve damage in the feet is common in diabetes, which may lead to Charcot’s joint. A loss of nerve function leads to numbness. People who walk on numb feet are more likely to twist and injure ligaments without knowing it. This places pressure on the joints, which can eventually cause them to wear down. Severe damage leads to deformities in the foot and other affected joints. Bone deformities in Charcot’s joint may be prevented through early intervention. Signs of the condition include: painful joints swelling or redn Continue reading >>

Diagnosis

Diagnosis

Print Diabetic neuropathy is usually diagnosed based on your symptoms, your medical history and a physical exam. During the exam, your doctor is likely to check your muscle strength and tone, tendon reflexes, and sensitivity to touch, temperature and vibration. Your doctor may also conduct tests that include: Filament test. Sensitivity to touch may be tested using a soft nylon fiber called a monofilament. Nerve conduction studies. This test measures how quickly the nerves in your arms and legs conduct electrical signals. It's often used to diagnose carpal tunnel syndrome. Electromyography (EMG). Often performed along with nerve conduction studies, electromyography measures the electrical discharges produced in your muscles. Quantitative sensory testing. This noninvasive test is used to assess how your nerves respond to vibration and changes in temperature. Autonomic testing. If you have symptoms of autonomic neuropathy, your doctor may request special tests to look at your blood pressure in different positions and assess your ability to sweat. The American Diabetes Association recommends that all people with diabetes have a comprehensive foot exam — either by a doctor or by a foot specialist (podiatrist) — at least once a year. In addition, your feet should be checked for sores, cracked skin, calluses, blisters, and bone and joint abnormalities at every office visit. Treatment Diabetic neuropathy has no known cure. Treatment for diabetic neuropathy focuses on: Slowing progression of the disease Relieving pain Managing complications and restoring function Slowing progression of the disease Consistently keeping blood sugar within a target range can help prevent or delay the progression of diabetic neuropathy and may even improve some of the symptoms you already have. Continue reading >>

What Drugs Work Best For Diabetic Nerve Pain?

What Drugs Work Best For Diabetic Nerve Pain?

HealthDay Reporter FRIDAY, March 24, 2017 (HealthDay News) -- Nerve pain and numbness, also known as neuropathy, is a debilitating but common symptom of diabetes. Now, new research suggests certain drugs may outperform others in treating diabetic neuropathy. The new review of the data on the subject was led by Julie Waldfogel of Johns Hopkins Hospital in Baltimore. Her team noted that about half of people with diabetes have some form of nerve damage caused by high levels of blood sugar. However, not all of them will have symptoms such as pain, numbness and tingling in the legs and feet. In the new study, the Hopkins group reviewed 106 studies on pain relief for diabetic neuropathy. The researchers found "moderate" evidence that the antidepressants duloxetine (Cymbalta) and venlafaxine (Effexor) reduce diabetic nerve pain. However, they only found "weak" evidence that botulinum toxin (Botox), the anti-seizure drugs pregabalin (Lyrica) and oxcarbazepine (Trileptal), and drugs called tricyclic antidepressants and atypical opioids (drugs such as Tramadol) may help reduce pain. The researchers also noted that gabapentin (Neurontin, Gralise) works in a similar manner to pregabalin, and the review found gabapentin no more effective than a placebo. Long-term use of standard opioids -- such as OxyContin, Vicodin or Percocet -- is not recommended for chronic pain due, including neuropathy, because of a lack of evidence of long-term benefit and the risk of abuse, misuse and overdose, Waldfogel said. The anti-seizure drug valproate and capsaicin cream were also ineffective, according to the review published online March 24 in the journal Neurology. The review was funded by the U.S. Agency for Healthcare Research and Quality. "Providing pain relief for neuropathy is crucial to manag Continue reading >>

Pain Reliever Lowers Blood Sugar For Type 2: Study

Pain Reliever Lowers Blood Sugar For Type 2: Study

MONDAY, July 1 (HealthDay News) -- An aspirin -like drug appears to lower blood sugar in people with type 2 diabetes , according to new research. A study of the drug -- the prescription pain reliever salsalate -- also found it reduced inflammation associated with type 2 diabetes . But it produced unwelcome side effects that could limit its potential as a diabetes treatment . "This trial is a test of possibly the oldest drug in Western use, and, because it's so old, there are no clinical trials on it," said study senior author Dr. Steven Shoelson, a professor of medicine at Harvard Medical School in Boston. "This trial was for a full year and showed that salsalate does lower blood glucose ," said Shoelson, who is also the associate research director at the Joslin Diabetes Center in Boston. The study, published in the July 2 issue of the Annals of Internal Medicine, included 286 people between 18 and 75 years old with type 2 diabetes . Type 2 diabetes occurs when the body no longer produces enough of the hormone insulin to convert carbohydrates from food into fuel for the body. At the start of the study, the participants' average A1C levels -- a measure of blood sugar levels over several months -- were between 7 and 9.5 percent. The American Diabetes Association generally recommends a level of below 7 percent for adults. The study volunteers were randomly assigned to 48 weeks of salsalate at a dose of 3.5 grams per day, or to an inactive placebo pill. No other changes were made to current diabetes, blood pressure or cholesterol medications during the first six months of the trial, the researchers noted. Over 48 weeks, people taking the medication saw their A1C levels drop by 0.37 percent compared to placebo. Shoelson said that people who have metabolic syndrome -- a grou Continue reading >>

Pain Medicines For Diabetic Neuropathy - Topic Overview

Pain Medicines For Diabetic Neuropathy - Topic Overview

Pain Medicines for Diabetic Neuropathy - Topic Overview Articles OnPain Medicines for Diabetic Neuropathy Duloxetine ( Cymbalta ), which is an antidepressant. It may cause dry mouth , nausea , constipation , diarrhea , and sometimes dizziness and hot flashes . Anticonvulsants such as carbamazepine , gabapentin , and pregabalin . Anticonvulsants are also frequently prescribed to reduce pain linked with diabetic neuropathy . Lidocaine or mexiletine . Lidocaine comes as a patch that you can put on your skin where the pain is the worst. Mexiletine is an oral medicine similar to lidocaine. Both medicines are used to relieve pain caused by neuropathy . Capsaicin cream. Capsaicin is a substance contained in cayenne peppers. Although it may not provide complete pain relief, it may help relieve minor pain in some people. Capsaicin cream is applied directly to the skin over the painful area. Nonprescription pain relievers. These include acetaminophen and nonsteroidal anti-inflammatory drugs ( NSAIDs ), such as aspirin , ibuprofen , or naproxen . Although they may provide some temporary pain relief, they are not effective for long-term treatment of severe pain. Note: People with diabetes need to be especially careful when taking NSAIDs because these medicines may upset kidney function. Be safe with medicines. Read and follow all instructions on the label. Narcotic pain relievers such as oxycodone , which may reduce moderate to severe pain from diabetic neuropathy . But narcotics are usually only given to people who do not have a personal or family history of addiction . Narcotics may also cause side effects that could make symptoms of autonomic neuropathy worse. So narcotics are not often the first type of medicine tried for symptoms of diabetic neuropathy. If you begin taking an Continue reading >>

How Pain Relievers Can Affect Blood Sugar Levels

How Pain Relievers Can Affect Blood Sugar Levels

Many of us don’t even think about our blood sugar levels when we’re scrabbling through the medicine cabinet, looking for a pain reliever. We just want to make the pain disappear—stat. But people with diabetes do need to take that matter into consideration when they’re taking any medication. If you have type 2 diabetes, your doctor or diabetes educator has probably warned you to be vigilant about the effects that that your diet, your activity level, and any other medication you take on a regular basis can have on your blood sugar levels. You also need to be careful about any pain relieving medication that you take, even if it’s just on an occasional basis, because certain types of pain killers can lower or raise your blood sugar levels. NSAIDs There are times when you can easily treat pain with an over-the counter pain reliever. You may take a low dose of aspirin or a nonsteroidal anti-inflammatory drug (NSAID) like ibuprofen or naproxen to relieve the occasional headache or muscle pain. A regular dose is unlikely to affect your blood sugar levels, but a higher-than-usual dose may lower your blood sugar level. Talk to your doctor about what’s an appropriate dose for your occasional aches and pains so you don’t accidentally cause an episode of hypoglycemia. Another word of caution. You might have settled on an effective dose of a particular pain reliever that won’t drastically alter your blood sugar levels. But your diabetes puts you at elevated risk for certain other health conditions. So you may have other medical conditions you need to manage—and you will need to watch out for the effect any pain killers you take can have on those. For example, NSAIDS like ibuprofen and naproxen can increase your blood pressure. And they can affect your kidneys, too, Continue reading >>

Medications To Treat Diabetic Peripheral Neuropathy

Medications To Treat Diabetic Peripheral Neuropathy

Medications are used to control the pain associated with peripheral diabetic neuropathy. Unfortunately, at this time, there aren’t any medications to treat and prevent diabetic nerve pain (another name for diabetic neuropathy); the only way to do that is through careful control of blood glucose levels. There are many medication options to relieve pain associated with peripheral nerve damage. You should work carefully with your doctor to figure out what medications are best for you. If you’d like to learn more about treatments for the other types of diabetic neuropathy, this section of the article reviews treatment options for autonomic, proximal, and focal neuropathy. Medication Warning Because of the possible interactions and side effects, always discuss medications with your doctor—even if they’re “just” over-the-counter. This is particularly important when you have diabetes because these over-the-counter medications may have interactions with other medications you’re using. Over-the-counter Medications for Diabetic Peripheral Neuropathy For people in the early stages of diabetic neuropathy—when the pain isn’t severe—over-the-counter medications may be enough to relieve the pain. However, people with more advanced nerve damage may not find over-the-counter medications helpful. For diabetic neuropathy, you may want to try: Acetaminophen: This is a painkiller, also known as an analgesic. Tylenol is an example of acetaminophen, and it works by blocking pain messages to the brain. In essence, acetaminophen makes it harder for the “pain” signal to travel through the nerves and to the brain, and therefore, the brain doesn’t know that it should be feeling pain. Possible side effects include liver damage, but that’s after taking large quantities fo Continue reading >>

Managing Chronic Pain

Managing Chronic Pain

Pain affects millions of people with diabetes. For most of these people, the pain is chronic, defined as pain persisting for more than six months, experienced almost every day, and of moderate to severe intensity, or that significantly interferes with daily activities. In some cases, a person’s pain is clearly related to complications of diabetes; in other cases, it is not. Regardless of the cause, however, studies show that chronic pain makes diabetes self-management much more difficult and often leads to higher blood glucose levels. Surveys of people with diabetes report rates of chronic pain anywhere from 20% to over 60% – much higher than rates in the general population. The types of pain most often reported by people with diabetes include back pain and neuropathy pain in the feet or hands. (Peripheral neuropathy, or nerve damage in the feet and hands, is a common complication of diabetes.) Headaches and other pain sites are also frequently reported. Many people with diabetes also have arthritis, fibromyalgia (an arthritis-related illness that causes widespread muscle and joint pain and fatigue), or other painful conditions. Pain has been shown to interfere with self-management activities, sleep, physical functioning, work, family relationships, mood, and quality of life. To make matters worse, pain is often invisible to others, so family members, coworkers, and health-care professionals often have no idea what a person in pain is going through. Many people feel that their physicians don’t understand and tell them they “just have to live with it.” Why is there so much pain, and what can be done about it? Acute versus chronic pain When speaking of pain, it’s important to understand the difference between acute and chronic pain. Acute pain is what a person Continue reading >>

Diabetic Neuropathy Medication: Nonsteroidal Anti-inflammatory Drugs (nsaids), Analgesic, Topical, Anticonvulsant, Antidepressant, Tricyclic, Antidepressant, Selective Serotonin/norepinephrine Reuptake Inhibitor (ssnri), Antidepressant, Serotonin Reuptake Inhibitor, Antiarrhythmic Agent, Class I-b, Prokinetic Agents, Antidepressant, Tetracyclic, Synthetic Adrenocortical Steroids, Cholinergic Agent, Laxative, Bowel Evacuant

Diabetic Neuropathy Medication: Nonsteroidal Anti-inflammatory Drugs (nsaids), Analgesic, Topical, Anticonvulsant, Antidepressant, Tricyclic, Antidepressant, Selective Serotonin/norepinephrine Reuptake Inhibitor (ssnri), Antidepressant, Serotonin Reuptake Inhibitor, Antiarrhythmic Agent, Class I-b, Prokinetic Agents, Antidepressant, Tetracyclic, Synthetic Adrenocortical Steroids, Cholinergic Agent, Laxative, Bowel Evacuant

For the treatment of diabetic neuropathy, acute cases may be able to be managed with standard analgesics, but other agents will likely be necessary for chronic pain. Occasionally, muscle relaxants may be of benefit in the first 2 weeks of therapy. Each type of pain or a combination of pain types should be treated. Reevaluation of the painful neuropathy should be performed every 6 weeks. [ 96 ] Every effort should be made to taper and eventually to stop therapies. Therapies may need to be reinstated at later dates if symptoms flare up. The pharmacologic agents listed below are commonly used for the symptomatic treatment of diabetic neuropathy. Most are not specifically approved by the United States Food and Drug Administration for this use, however. [ 18 , 80 , 82 , 83 , 67 , 25 , 20 , 97 , 98 , 99 ] Zeng L, Alongkronrusmee D, van Rijn RM. An integrated perspective on diabetic, alcoholic, and drug-induced neuropathy, etiology, and treatment in the US. J Pain Res. 2017 Jan 20. 10:219-228. [Medline] . [Full Text] . Boulton AJ, Malik RA. Diabetic neuropathy. Med Clin North Am. 1998 Jul. 82(4):909-29. [Medline] . Juster-Switlyk K, Smith AG. Updates in diabetic peripheral neuropathy. F1000Res. 2016. 5: [Medline] . [Full Text] . Bromberg MB. Peripheral neurotoxic disorders. Neurol Clin. 2000 Aug. 18(3):681-94. [Medline] . Goetz CG, Pappert EJ. Textbook of Clinical Neurology. Philadelphia: WB Saunders Co; 1999. Pourmand R. Diabetic neuropathy. Neurol Clin. 1997 Aug. 15(3):569-76. [Medline] . Sugimoto K, Murakawa Y, Sima AA. Diabetic neuropathy--a continuing enigma. Diabetes Metab Res Rev. 2000 Nov-Dec. 16(6):408-33. [Medline] . Vinik AI, Park TS, Stansberry KB, Pittenger GL. Diabetic neuropathies. Diabetologia. 2000 Aug. 43(8):957-73. [Medline] . Wilson JD. Williams Textbook o Continue reading >>

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