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What Causes Sudden Onset Of Diabetic Neuropathy?

Posted on Fri, 4 Jul 2014

Question: Dear Doc - This is with regards to my mother who is 71 year old , Diabetic , CABG , CKD . Since last night she is having episodes of PDN (Painful Diabetic Neuropathy) . She is on insulin [Lantus - 8 units , XXXXXXX Rapid 8-8-6 units] , To manage neuropathy she is already taking Pregabalin 75 twice a day [ 1-0-1] and Tryptomer 50 at night . My question is why this sudden episode of PDN and also how to manage the same ?

Answered by Dr. Dr. Phanindra Dulipala (1 hour later)

Brief Answer:
See that blood sugar levels are in strict control.

Detailed Answer:
Hi, I had gone through your query and understood your concerns.

Sir, let me appreciate you for your concern to the condition of the mother. Diabetic neuropathy is a complication arising from long standing uncontrolled sugar levels. So, the most probable reason for this episode is uncontrolled sugar levels. Please check the sugar levels of your mother. HbA1c gives better idea of sugar control. So please get it done. If it is already done please mention the value.

If I were her treating doctor, i would prescribe her a NSAID like aspirin temporarily for 3-4 days to relieve acute pain, but not for long term use as already has kidney disease. Check the blood sugar levels, and set the dosage of insulin accordingly to keep the sugar levels under strict control. You can discuss this with your treating doctor.

Hope this guides you. For any other queries you can write to us. we will be happy to help you. Wish you good health. Thank you.
Dr Phanindra Dulipala
Diabetologist.

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Dr. Phanindra Dulipala (18 hours later)

Dear Doc - Thank you for your reply . While I would be adjusting the insulin dosage to keep the sugar under control , is there any medicine which could be given for a temporary basis to alleviate her pain ? She already takes Clodrel Plus (which contains Aspirin 75) on a daily basis , along with Pregabalin 75 (Twice a day) ....This is the first time when her Neuropathic pain has continued for more than 24hours (with varying intervals in between)...Wondering if Gabapentin can be introduced for a week to manage the pain ? Request you to kindly advice considering her medical condition . Thanking you once again, for your inputs and recommendations.

Answered by Dr. Dr. Phanindra Dulipala (16 minutes later)

Brief Answer:
Replace Pregabilin with Gabapentin

Detailed Answer:
Hi Mr. XXXXXXX welcome back to HCM.

Yes, If that is the case, then I advice addition of Gabapentin 75mg once daily stopping pregabilin. Both the drugs are not needed. Your treating doctor will be knowing this. And then get the insulin dosage get adjusted as soon as possible.

Hope I have answered your query. If you have any further questions I will be happy to help. If you do not have any clarifications, you can close the discussion and rate the answer. Wishing your mother good health.
Dr Phanindra Dulipala
Diabetologist.

Note: For further follow-up, discuss your blood glucose reports with our diabetologist. Click here.

Above answer was peer-reviewed by : Dr. Prasad