How can I prevent or delay diabetic neuropathy?

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Ronald Tamler, MD
Endocrinology Diabetes & Metabolism

The best way to prevent diabetic neuropathy is to keep your blood sugar level at goal. Studies have shown that patients with well-controlled diabetes have lower likelihood of developing or worsening diabetic neuropathy. That said, 10-20% of patients with type 2 diabetes have diabetic neuropathy at the time of their diagnosis, and I even have some patients with prediabetes, when the blood sugar is not even that high, who have the kind of neuropathy one would see with diabetes.

There are two very basic kinds of neuropathy: One is painful neuropathy, in which patients feel like their feet are burning, hurting, and sometimes extremely sensitive to the lightest touch. Often their symptoms are worse at night. The other kind is the exact opposite, when patients are increasingly losing the ability to feel anything, usually in their feet. The two are treated very differently. A consultation with a specialist can provide useful insight into what is going on and what treatment plan could work best for the individual patient.

Diabetic neuropathy can be prevented by long term, aggressive blood sugar control which means ideally your fasting blood sugar should always be 70-110 mg/dL and your hemoglobin A1C (HBA1C) should be less than 6.5% (recommendations are based on the American Association of Clinical Endocrinologists). In addition, a healthy life style consisting of regular exercise, a low fat and carbohydrate diet, weight loss and quitting smoking will also help lower your blood glucose levels and thus prevent diabetic neuropathy.   
There's a lot you can do to prevent or delay nerve damage. And, if you already have diabetic neuropathy (nerve damage), these steps can prevent or delay further damage and may lessen your symptoms.

Keep your blood glucose levels in your target range. Meal planning, physical activity and medications, if needed, all can help you reach your target range. There are two ways to keep track of your blood glucose levels:
  • Use a blood glucose meter to help you make decisions about day-to-day care.
  • Get an A1C test (a lab test) at least twice a year to find out your average blood glucose for the past 2 to 3 months.
Checking your blood glucose levels will tell you whether your diabetes care plan is working or whether changes are needed.
  • Report symptoms of diabetic neuropathy.
  • If you have problems, get treatment right away. Early treatment can help prevent more problems later on. For example, if you take care of a foot infection early, it can help prevent amputation.
  • Take good care of your feet. Check your feet every day. If you no longer can feel pain in your feet, you might not notice a foot injury. Instead, use your eyes to look for problems. Use a mirror to see the bottoms of your feet. Use your hands to feel for hot or cold spots, bumps or dry skin. Look for sores, cuts or breaks in the skin. Also check for corns, calluses, blisters, red areas, swelling, ingrown toenails and toenail infections. If it's hard for you to see or reach your feet, get help from a family member or foot doctor.
  • Protect your feet. If your feet are dry, use a lotion on your skin but not between your toes. Wear shoes and socks that fit well and wear them all the time. Use warm water to wash your feet, and dry them carefully afterward.
  • Get special shoes if needed. If you have foot problems, Medicare may pay for shoes. Ask your health care team about it.
  • Be careful with exercising. Some physical activities are not safe for people with neuropathy. Talk with a diabetes clinical exercise expert who can guide you.

Continue Learning about Diabetic Neuropathy (Nerve Damage)

Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.