Causes of Diabetic Nerve Pain

The nerve damage due to diabetes is usually seen in the feet and legs and, less often, in the hands and arms. The pain usually occurs in both feet and may seem to extend into the legs as time passes. Similarly, both hands would be affected, and this pain may travel up the arms. DNP can be painful or nonpainful. The pain can develop on its own, or it may also be caused by light touch or movement.

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. While diabetic nerve pain can occur at any time, those who have had diabetes for a long time may be more likely to develop the painful symptoms. People who have had problems controlling their blood sugar levels, have high blood pressure, are overweight, or have had diabetes for many years may also have a greater risk of developing diabetes-related nerve damage.

Fortunately, research has shown that diabetic neuropathy may be prevented through improved control of blood sugar. Other measures to improve your overall health include maintaining a healthy diet, exercising, lowering your blood pressure, lowering your cholesterol, avoiding smoking, and reducing the amount of alcohol you drink.

Note: Before beginning or changing an exercise program, please consult your healthcare professional.

And there are effective options to help manage diabetic nerve pain, such as Cymbalta or nonmedicinal treatments, like acupuncture. Ask your doctor what you can do.



Antidepressants can increase suicidal thoughts and behaviors in children, teens, and young adults. Suicide is a known risk of depression and some other psychiatric disorders. Call your doctor right away if you have new or worsening depression symptoms, unusual changes in behavior, or thoughts of suicide. Be especially observant within the first few months of treatment or after a change in dose. Approved only for adults 18 and over.

What should I talk about with my healthcare provider?
Patients on antidepressants and their families or caregivers should watch for new or worsening depression 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.

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 (increased eye pressure)
You are taking Mellaril® (thioridazine)

What other important information should I discuss with my healthcare provider?
Before starting Cymbalta, talk with your healthcare provider:
about all of your medical conditions, including kidney or liver problems, glaucoma,  diabetes, seizures, or if you have bipolar disorder. Cymbalta may worsen a type of glaucoma or the control of blood sugar in some patients with 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, talk with 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
about your blood pressure. Cymbalta can increase your blood pressure. Your healthcare provider should check your blood pressure prior to and while taking Cymbalta
if you experience headache, weakness, confusion, problems concentrating, memory problems, or feel unsteady while taking Cymbalta which may be signs of low sodium levels
if you develop problems with urine flow

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. Other common side effects included dry mouth, sleepiness, constipation, decreased appetite, and, increased sweating. This is not a complete list of side effects.

Other safety information about Cymbalta:
Cymbalta may cause sleepiness and dizziness. Until you know how Cymbalta affects you, you should not drive a car or operate hazardous machinery.

Please read additional Safety Information and Boxed Warning for a complete list.
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