Table 7—

Initial management of symptomatic neuropathy

1) Exclude nondiabetic causes
 • Malignant disease (e.g., bronchogenic carcinoma)
 • Metabolic
 • Toxic (e.g., alcohol)
 • Infective (e.g., HIV infection)
 • Iatrogenic (e.g., isoniazid, vinca alkaloids)
 • Medication related (chemotherapy, HIV treatment)
2) Explanation, support, and practical measures (e.g., bed cradle to lift bed, clothes off hyperesthetic skin)
3) Assess level of blood glucose control profiles
4) Aim for optimal stable control
5) Consider pharmacological therapy