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.



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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