Diabetic Neuropathy

Home Treatment

In addition to having regular medical checkups, the best way to avoid the progression of diabetic neuropathy is to control your blood sugar, take good care of your feet, and practise wise health habits.

Control your blood sugar level

The single most important step you can take to prevent the development and progression of diabetic neuropathy is to keep your blood sugar level consistently within a tightly controlled and narrow target range. Tight blood sugar control means a near normal level of hemoglobin A1c (HbA1c).

Keeping your blood sugar level within the target range also helps decrease your chances of getting other complications from diabetes, such as eye disease and kidney problems. For more information, see the topic Type 1 Diabetes: Living With the Disease or Type 2 Diabetes: Living With the Disease.

Take care of your feet

Diabetic neuropathy affects the feet more often than any other part of the body. Diabetes interferes with your body's ability to fight infection, so that even a minor foot injury, such as a blister or scratch, or athlete's foot can lead to serious infections or amputation. However, serious foot problems are the most preventable complications of diabetes.

Because the nerve damage caused by diabetic neuropathy may make you less likely to notice minor problems with your feet, it is wise to inspect your feet every day. Protect them from injury by wearing properly fitted shoes and socks at all times. If vision problems from diabetic retinopathy or another eye disease make it difficult for you to examine your feet, have someone assist you. Ask your doctor to check your feet at each visit, and have a thorough medical examination of your feet at least once a year, or more often if you are at risk of having foot problems, such as if you have neuropathy or had foot problems before. For more information, see:

Foot care for people with diabetes.

If you have severe numbness, a history of skin sores, or bone and joint deformities (such as Charcot foot), you may benefit from custom-fitted shoes. Provincial health plans may pay for these shoes if they are needed.

Practise wise health habits

Many health professionals believe that you can further reduce your risk of getting severe neuropathy if you:

• See your doctor regularly. Your doctor will be able to note any changes in your health more easily when you plan regular visits. It will be easier for you and your doctor to find problems early and to take care of them right away.
• Control your blood pressure. Neuropathy may be more likely to progress in people who have high blood pressure. It is not clear whether treating high blood pressure can directly affect the progression of neuropathy, but in general, keeping blood pressure as close to normal as possible may reduce the risk of the complications from diabetes. For more information, see the topic High Blood Pressure.
• Exercise regularly and maintain a healthy weight. Exercise and weight control can help your body use insulin better. This helps keep your blood sugar level within a tightly controlled and narrow target range, which may help prevent the development and progression of nerve damage. Talk to your doctor and have a thorough examination of your feet before beginning an exercise program. Foot problems, blood pressure problems, or certain other problems associated with neuropathy may raise unique concerns about exercising safely, such as whether you should avoid repetitive, weight-bearing exercises.
• Limit your alcohol intake. Having four or more drinks per week may make neuropathy and its symptoms worse.
• Eat a balanced diet. Consider taking a daily multivitamin to ensure that you are meeting your nutritional needs. A balanced diet can also help you maintain a healthy weight. If you have gastroparesis, eat several small meals a day instead of three regular meals.

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Author:	Carrie Henley Monica Rhodes	Last Updated: July 28, 2006
Medical Review:	Caroline S. Rhoads, MD - Internal Medicine Tom Bailey, MD - Family Medicine Barrie J. Hurwitz, MD - Neurology
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