NERVE DAMAGE FROM diabetes – also called neuropathy – occurs in about half of all people with diabetes, according to the American Diabetes Association.
There are several different types of neuropathy, and some even affect your organs, like your eyes. With peripheral neuropathy, which is the kind of neuropathy that affects your feet or hands, symptoms can vary from pain to tingling to numbness or a “pins and needles” feeling.
Because neuropathy becomes more common the longer you have diabetes, Grace Derocha, a certified diabetes educator and registered dietitian with Blue Cross Blue Shield of Michigan, has had clients ask, “How much time before I get it?” The truth is that it varies from person to person. Some factors that can raise your risk for neuropathy, include obesity, smoking, high blood pressure and coronary artery disease.
Here are some ways to help prevent and manage peripheral neuropathy.
Keep your blood sugar under control. You’ve heard this advice before, but it bears repeating. Diabetic nerve damage is caused by poor blood sugar control over time. “Excellent blood glucose control is important in both preventing diabetic neuropathy and keeping existing neuropathy from worsening,” says certified registered nurse practitioner Kristin Brown of The Diabetes Center, which is part of The Center for Endocrinology at Mercy Medical Center in Baltimore. Eat a healthy diet and take your medications or insulin as directed. If necessary, work with a registered dietitian to help with meal planning.
Wear shoes that fit you well. This is because ill-fitting shoes could irritate your feet. However, if you don’t have feeling in your feet, you may not know it. Work with a podiatrist to find the right-fitting shoes and socks for you.
Don’t go barefoot – even on the beach. You may feel you’re missing out in the summer, but it’s not worth it if you get a cut and don’t realize it, leading to an infection, says registered dietitian and certified diabetes educator Ginny Mirenzi, education coordinator at the Center for Diabetes and Endocrinology at the University of Maryland Baltimore Washington Medical Center. Untreated infections can lead to other health problems and conditions and raise the risk of amputations, which are more common in those with diabetes. In fact, Derocha has had patients who have lost limbs up to their thighs due to poor blood sugar control. “You don’t necessarily feel awful now, but the consequences [of poor blood sugar control] can be devastating,” she says.
Diabetic Neuropathy Symptoms and Treatment
Inspect and clean your feet daily. If you don’t have feeling in your feet, you may not know if you’ve stepped on a thumbtack or a piece of glass, leaving your foot with an untreated injury. Look closely at your feet daily – use a mirror if necessary – and check for sores, cuts, blisters, calluses, ingrown toenails, toenail fungus, redness or signs of infections. “A good self-exam includes checking between toes and the bottom and sides of the feet,” Brown says.
Keep moving. Exercise helps to improve circulation in your hands and feet, and that can help you fight neuropathy. A physical therapist or exercise specialist can advise you on safe exercises to avoid injury, Brown says.
See your doctor regularly. Generally speaking, people with diabetes will see their doctor every three months. If you think you’ve developed any of the symptoms of neuropathy, let him or her know. That can prompt testing for neuropathy or treatments that may help the condition. Your primary care doctor should regularly examine your feet for any issues. Take off your shoes and socks during your appointments to help remind your doctor to do the check, Mirenzi suggests.
You should use your exams to bring up any new or unusual symptoms or sensations that you have. “When you see your doctor, always update them on what’s going on,” Mirenzi says.
Regular exams with other key health care providers, such as dentists, eye doctors and podiatrists also will help boost your overall health, Brown says. Better overall health can lessen your chance of blood sugar problems.
Consider acupuncture. The ancient Chinese approach of acupuncture helps to restore qi, or energy, to your body. Although it doesn’t work for everyone, Derocha has some patients who have found it helps neuropathy over the long term. This usually means trying more than one session.
Try capsaicin cream. Capsaicin is what makes hot peppers hot, and some people find that that the cream helps reduce pain from peripheral neuropathy. You apply the cream a few times a day. Just be careful when applying it, as it can get messy.
Try supplements. Alpha lipoic acid, found in foods like spinach, carrots, broccoli and potatoes, is an antioxidant that is found in some studies to help control blood sugar. It is also thought to help the symptoms of diabetic neuropathy, according to the University of Maryland Medical Center. The food sources usually have low levels of alpha lipoic acid, and that’s why some people with the condition try supplements. A vitamin deficiency linked to nerve pain is B-12, which leads some people to try B-12 supplements, Mirenzi says. Ask your doctor about any side effects from supplements and if you should avoid any supplements due to any other medications you use.
Stay away from anything that claims it’s a cure-all for neuropathy. When people are in a lot of pain, they’re more willing to try different things to help. However, if there was one cure-all for neuropathy, everyone would be using it, Derocha says. Watch out for any treatment that is costly or sounds fishy.
Ask your doctor about medications for neuropathy. The suggestions here to help peripheral neuropathy are meant to be used in addition to any medications your doctor may recommend. Common medications prescribed for neuropathy include tricyclic antidepressants (although they are not used for depression when treating neuropathy), duloxetine, gabapentin and pregabalin.