Information for Friends and Family

Diabetic nerve damage can affect people with type 1 or type 2 diabetes. No one yet knows exactly what causes the nerve damage. Having high blood sugar (glucose) levels over time is likely to be involved. People who have had problems controlling their blood sugar levels, have high blood pressure, are overweight, or have had diabetes for at least 25 years may also have a greater risk of developing diabetes-related nerve damage.

Fortunately, research has shown that diabetic neuropathy can be prevented through improved control of blood sugar. Some ways you can play a role in helping your loved one manage their diabetes and blood sugar include:

Your support is vital, and your loved one will appreciate your kindness and compassion.

Tools and Resources

Use the tools and resources below to help your loved one with diabetic nerve pain.

Where Your Loved One Can Find Support

American Diabetes Association
Nonprofit health organization founded in 1940 providing diabetes research, information, and advocacy.
www.diabetes.org

National Institutes of Health (NIH)
An agency of the US Department of Health and Human Services responsible for medical research.
www.nih.gov

The Neuropathy Association
Information and advocacy to better understand neurological disorders known as neuropathies.
www.neuropathy.org

Centers for Disease Control and Prevention (CDC), Division of Diabetes Translation
A division of the CDC, dedicated to diabetes research.
www.cdc.gov/diabetes

National Diabetes Education Program (NDEP)
Partnered with the NIH and the CDC, this organization works to reduce the negative impact of living with diabetes.
www.ndep.nih.gov

American Podiatric Medical Association (APMA)
Providing foot health information to the public.
www.apma.org

Lower Extremity Amputation Prevention (LEAP)
A prevention program designed to reduce the occurrence of amputations of the toes, feet, or legs in patients with diabetes.
http://www.hrsa.gov/leap



Cymbalta® (duloxetine HCl) is approved for the treatment of depression and generalized anxiety disorder, and for the management of diabetic peripheral neuropathic pain and fibromyalgia. What should I talk about with my healthcare provider? Patients on antidepressants and their families or caregivers should watch for new or worsening symptoms, unusual changes in behavior, thoughts of suicide, anxiety, agitation, panic attacks, difficulty sleeping, irritability, hostility, aggressiveness, impulsivity, restlessness, or extreme hyperactivity. Call your healthcare provider right away if you have thoughts of suicide or if any of these symptoms are severe or occur suddenly. Be especially observant within the first few months of antidepressant treatment or whenever there is a change in dose. You should also know that: Suicide is a known risk of depression and some other psychiatric disorders. Antidepressants may increase suicidal thoughts or behaviors in some children, adolescents, and young adults especially within the first few months of treatment or when changing the dose. No increased risk has been shown for adults over age 24, and risk decreased for those over age 65. All patients starting therapy should be monitored appropriately and observed closely for new or worsening depression symptoms, suicidal thoughts or behavior, or unusual changes in behavior. Cymbalta is not approved for use in patients under age 18. Who should NOT take Cymbalta? You should not take Cymbalta if: You have recently taken a type of antidepressant called a monoamine oxidase inhibitor (MAOI) You have uncontrolled narrow-angle glaucoma (an eye disease) You are taking Mellaril® (thioridazine) What other important information should I discuss with my healthcare provider? Before starting Cymbalta, tell your healthcare provider: about all of your medical conditions, including kidney problems, glaucoma, or diabetes about your alcohol use if you are taking nonprescription or prescription medicines, including those for migraine, to address a possible life-threatening condition if you are taking NSAID pain relievers, aspirin, or blood thinners. Use with Cymbalta may increase bleeding risk if you are pregnant, plan to become pregnant during therapy, or are breastfeeding an infant While taking Cymbalta, tell your healthcare provider: if you have itching, right upper belly pain, dark urine, yellow skin/eyes, or unexplained flu-like symptoms, which may be signs of liver problems. Severe liver problems, sometimes fatal, have been reported if you have high fever, confusion, and stiff muscles to address a possible life-threatening condition before stopping Cymbalta or changing your dose if you experience dizziness or fainting upon standing, especially when first starting Cymbalta or when increasing the dose. Your healthcare provider may periodically check your blood pressure while you are taking Cymbalta If you have any questions, talk to your healthcare provider before taking Cymbalta. What are the possible side effects of Cymbalta? The most common side effect of Cymbalta was nausea. For most people who had it, the nausea was mild to moderate. Other common side effects included dry mouth, sleepiness, constipation, decreased appetite, and increased sweating. This is not a complete list of side effects. Please read additional Safety Information and Boxed Warning for a complete list.
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