Treatment
Glycemic Control
Tight glycemic control, implemented
early in the course of diabetes, has
been shown to effectively prevent or delay
the development of DPN and CAN in
patients with type 1 diabetes (70–73).
While the evidence is not as strong for
type 2 diabetes, some studies have
demonstrated a modest slowing of progression
(74,75) without reversal of
neuronal loss. Several observational
studies further suggest that neuropathic
symptoms improve not only with optimization
of glycemic control but also
with the avoidance of extreme blood
glucose fluctuations.