No. Diabetic neuropathy cannot be cured, and nerve damage that has already occurred generally does not reverse. What glucose control does is slow further damage, most convincingly in type 1 diabetes. The pain is treatable separately and often well, and foot care prevents the complications that actually change people's lives.
No. Diabetic neuropathy cannot be cured, and nerve damage that has already occurred generally does not reverse. What glucose control does is slow further damage, most convincingly in type 1 diabetes. The pain is treatable separately and often well, and foot care prevents the complications that actually change people's lives.
Tight glucose control clearly reduces the development and progression of neuropathy in type 1 diabetes. In type 2 the effect on nerves is real but smaller, because blood pressure, lipids, obesity and vascular disease all contribute alongside glucose. This is worth stating plainly, because patients who bring their numbers down and find their feet still burn are often told they must not be trying hard enough. Control protects the nerves you still have; it does not rebuild the ones you have lost.
Neuropathic pain responds to a specific group of medications rather than to ordinary painkillers: certain anti-seizure drugs such as gabapentin and pregabalin, the antidepressants duloxetine and venlafaxine, and tricyclics including amitriptyline and nortriptyline. Topical agents suit small, well-localised areas. Each is started low and increased gradually, and the honest expectation is meaningful reduction rather than absence of pain. Opioids are not appropriate long-term treatment for this.
Pain brings people to the clinic; numbness is what causes amputations. A foot that cannot feel a blister, a stone in a shoe or a burn from hot pavement, which in Las Vegas is a genuine hazard, develops an ulcer that goes unnoticed. Daily inspection including between the toes, never walking barefoot outdoors, checking inside shoes before putting them on, and prompt attention to any break in the skin do more to protect a limb than any medication in this article.
Not every neuropathy in a person with diabetes is diabetic neuropathy, and assuming otherwise misses treatable causes: B12 deficiency, which metformin can contribute to, thyroid disease, alcohol, and immune neuropathies that need entirely different treatment. Asymmetry, rapid progression or prominent weakness argue against a simple diabetic cause. EMG and nerve conduction studies characterise the pattern, and both offices operate AANEM-accredited electrodiagnostic laboratories.
Clinical Neurology Specialists has been physician-owned since 1998, when Leo Germin, M.D., FAANEM founded it. Five board-certified neurologists and four advanced practice providers see patients at the Las Vegas and Henderson offices, each with its own AANEM-accredited electrodiagnostic laboratory.
Clinical Neurology Specialists is an adult outpatient neurology practice for patients 18 and older. The practice performs no surgery and operates no imaging suite, infusion suite or interventional pain programme, and provides no emergency or inpatient care.
Physician-reviewed. Reviewed by the physicians of Clinical Neurology Specialists — board-certified neurologists, AANEM-accredited electrodiagnostic laboratories, physician-owned since 1998. Reviewed 1 August 2026. This article is general education for adults 18 and older and is not a substitute for a consultation.
Sources and further reading: MedlinePlus: diabetic nerve problems; MedlinePlus: peripheral nerve disorders; National Institute of Neurological Disorders and Stroke.
Adults 18 and older, at the Las Vegas and Henderson offices. Call 702-804-1212 or request an appointment online.