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Diabetic Neuropathy: What Can I Do About It?

Source: American Family Physician, Nov 1, 2000

What is diabetic neuropathy?

Diabetic neuropathy is a kind of nerve damage that happens in people who have diabetes. This damage reduces the ability of the nerves to carry messages to the brain and other parts of the body. Diabetic neuropathy can affect the following:

* Strength and feeling in different parts of the body

* Ability of the heart to keep up with the needs of the body

* Ability of the intestines to digest food

* Ability to achieve an erection (in men)

What causes diabetic neuropathy?

Nerve damage occurs in people who have had diabetes for a long time. People who don't control (or can't control) their blood sugar very well seem more likely to get diabetic neuropathy. Men have diabetic neuropathy more often than women.

What can I do to avoid diabetic neuropathy?

Keep your blood sugar under control. You can do this by eating a variety of healthy foods and avoiding foods that are high in fat and carbohydrates (or sugar). If you are overweight, ask your doctor to help you lose weight. Exercise as regularly as possible. Take your medicines just the way your doctor tells you.

How do I know if I have diabetic neuropathy?

If you have numbness in your feet and toes, you may have diabetic neuropathy. Cuts and sores on your feet might not hurt as you would expect them to. If you have the following symptoms, you may have diabetic neuropathy:

* Pain in your legs

* A feeling of lightheadedness that causes you to fall

* Diarrhea and constipation

* Failure to get erections (in men)

What will happen if the nerves in my legs and feet are damaged?

If diabetic neuropathy has damaged the nerves in your legs and feet, you may not be able to feel pain in those parts of your body. Pain is a useful signal. If there is no feeling in your feet, you could have an injury and not know it. In addition, your muscles might atrophy (become small and weak), and you could have trouble walking. The skin on your feet might crack and make sores. Because diabetes can also keep an injury or a sore from healing, it's important to take good care of your feet.

What can I do to prevent foot problems from diabetic neuropathy?

You can help keep your feet healthy by following these tips:

* Look at your feet every day. Call your doctor at the first sign of redness, swelling, infection, prolonged pain, numbness or tingling in any part of a foot.

* Look inside your shoes every day for things like gravel or torn linings. These things could hurt your feet.

* Never walk barefoot around the house or outside.

* Have your doctor look at your feet at every office visit (at least one time every year) or whenever you notice anything that seems wrong.

* The most common reason for foot sores is a new pair of shoes or shoes that don't fit right. Buy shoes that fit well and have a good arch support. Choose shoes made of soft leather. They should not fit tightly anywhere. To get the best fit, try on shoes at the end of the day, when your feet are a little swollen. If you've had problems before because of shoes that didn't fit well, you may want to be fitted for a custom-molded shoe with a high toe box.

* Wear white socks and look at the socks when you take them off to see if there is any discharge (such as blood or fluid from a blister).

* Wash your feet every day and dry them carefully, especially between the toes. Use a soft towel and blot gently, don't rub. Keep the skin of your feet smooth by applying a cream or lanolin lotion, especially on the heels. If your feet sweat easily, keep them dry by dusting them with non-medicated powder before putting on shoes and stockings.



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