Am Fam Physician. 2005;71(11):2129-2130
See related article on diabetic neuropathy
What is diabetic neuropathy?
Diabetic neuropathy is nerve damage that happens in people with diabetes. It is more common in men than in women.
People with diabetic neuropathy can have numbness (loss of feeling), tingling, or pain in different parts of their body.
Most often, the nerves and skin of the feet are affected. Diabetic neuropathy also can affect other nerves and areas of skin, blood vessels, and the heart, bowel, bladder, or genitals.
What causes diabetic neuropathy?
If your blood sugar levels are high, you are more likely to get diabetic neuropathy. Over time, high blood sugar levels damage blood vessels and nerves.
What can I do to keep from getting diabetic neuropathy?
Treatment of diabetes can delay or prevent diabetic neuropathy. Here are some things you can do:
• Learn as much as you can about diabetes and how to control the disease. Work with your doctor to set goals, such as better blood sugar control and getting more exercise.
• Keep your blood sugar levels within your goal.
• Learn how a healthy diet and exercise can lower your blood sugar levels.
• If you have high blood pressure or a high cholesterol level, take your medicine. Tell your doctor if you cannot take your medicines in the way they are prescribed.
• If you are overweight, ask your doctor what you can do to lose weight.
• Do not use alcohol or tobacco.
Record keeping is important:
• Keep a list of all medicines, supplements (such as vitamins), and herbal products that you take. Write down how much and how often you take them.
• If you take insulin, keep a record of what type, how much, and when you take it.
• Write down your home blood sugar measurements. Also, write down things that upset your blood sugar level, such as certain foods or illness.
• Bring your medicine list, blood sugar record, and insulin record with you when you see your doctor.
What will happen if the nerves in my legs and feet are damaged?
If there is nerve damage, you may not be able to feel an injury in your legs and feet. You also may have tingling or pain. Your muscles may become weaker and smaller. You may have trouble walking.
The skin on your feet may get dry and cracked. You may get sores on your feet. Diabetes makes sores hard to heal.
What can I do to prevent foot problems from diabetic neuropathy?
It is important to keep tight control of your blood sugar levels. You also need to keep your feet healthy (see table).
Tips for Keeping Your Feet Healthy
Check your feet and shoes.
Have your doctor check your feet at least once a year or whenever you think anything seems wrong.
Check your feet every day when you take off your shoes. You may need to use a mirror to check the bottoms of your heels and feet. Also, check your socks for blood or wetness from a foot sore.
Check inside your shoes every day for torn linings, gravel, and other things that could hurt your feet.
Call your doctor if you have redness, swelling, infection, pain, numbness, or tingling in any part of your foot.
Take good care of your feet.
Wash your feet in lukewarm water every day. Dry your feet well, especially between your toes. Use a soft towel and blot gently (do not rub).
Keep the skin of your feet smooth by applying a cream or lanolin lotion.
If your feet sweat easily, dust them with nonmedicated powder (such as baby powder) before you put on your shoes and socks or nylons.
Keep your toenails trimmed correctly. If necessary, see a podiatrist (a doctor with special training in foot care).
Wear cotton socks. Change your socks every day.
Choose your shoes carefully.
The best shoes have a wide toe and good arch support.
If possible, buy your shoes from a store that has a salesperson who knows how to evaluate how shoes fit.
Try on shoes at the end of the day when your feet are normally a little swollen. Your podiatrist or family doctor may want to check your new shoes.
Break in new shoes slowly. Wear the shoes for 1 to 2 hours. Then check your feet for red spots. If you have red spots, do not wear the shoes again until the red spots are gone. Slowly break in new shoes by wearing them one hour longer each day every 3 days.
If you get calluses or sores from regular shoes, you may need foot orthotics (custom arch supports) or custom-molded shoes.
Avoid things that are bad for your feet.
Do not walk barefoot.
Do not wear stretch socks, nylon socks, socks with inside seams, or socks with an elastic band or garter at the top.
Do not put hot water, electric blankets, or heating pads on your feet.
Do not use hydrogen peroxide, iodine, or astringents (such as rubbing alcohol or witch hazel) on your feet.