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How to Treat Diabetic Neuropathy?


Medical Treatment:
Ensure appropriate glycaemic control.
Exclude or treat other contributory factors e.g:
  • Alcohol excess,
  • Vitamin B12 deficiency, if suspected,
  • Uraemia,and
  • HIV infection.
Pain
* Amitriptyline, oral, 10-25 mg at night increasing to 100 mg, if necessary.
AND/OR
* Paracetamol, oral, 1 g 6 hourly as needed.
If ineffective consider adding:
* Carbamazepine, oral, 100 mg daily.
  • Increase dose to 200 mg 12 hourly, if necessary.
  • Maximum dose: 1200 mg daily.
Gastroparesis
* Metoclopramide, oral, 10 mg 8 hourly before meals. If ineffective consult a specialist.