Diabetic Neuropathy

Medically reviewed by Drugs.com. Last updated on Nov 3, 2024.

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AMBULATORY CARE:

Diabetic neuropathy (DN)

is a type of nerve damage that can develop if you have diabetes. High blood sugar that is not controlled can damage nerves and slow or stop their ability to send signals. DN is most common in the legs and feet.

Common signs and symptoms:

You may have symptoms in your feet and legs first, then your hands and arms. Your symptoms may be worse at night:

• Numbness, decreased ability to feel pain or changes in temperature
• Burning, tingling, cramping, or pain in your feet or hands
• Increased sensitivity to touch
• Serious foot problems, such as sores, infection, calluses, or bone and joint pain
• Muscle weakness or problems balancing or walking

Seek care immediately if:

• Your legs or feet start to turn blue or black.
• You have a wound that does not heal or is red, swollen, or draining fluid.

Call your diabetes care team provider if:

• You begin to have symptoms.
• Your blood sugar level is higher or lower than care team providers have told you it should be.
• You have redness, calluses, or sores on your feet.
• You have questions or concerns about your condition or care.

Screening for DN:

You will be checked for DN when you are diagnosed with type 2 diabetes. You will need to be checked 5 years after a type 1 diabetes diagnosis. You will need yearly exams to check for symptoms of DN. Your healthcare provider will check the blood flow in your feet and look for ulcers or other problems. Your provider will tell you when to get checked.

Treatment for DN:

DN cannot be cured. The goal of treatment is to decrease pain, slow progression of DN, and prevent complications. You may be given medicines to help decrease nerve pain.

Manage DN:

• Keep your blood sugar levels as close to your target levels as possible. Check your blood sugar levels often, as directed. Contact your healthcare provider if your levels are higher than they should be.
• Care for your feet. Check your feet each day for cuts, scratches, calluses, or other wounds. Look for redness and swelling, and feel for warmth. Wear shoes that fit well. Check your shoes for rocks or other objects that can hurt your feet. Do not walk barefoot or wear shoes without socks. Wear cotton socks to help keep your feet dry.
• Work with your dietitian to create a healthy meal plan. This meal plan can help you control your blood sugar and decrease your symptoms.
• Be physically active at least 30 minutes, 5 days a week. This can help keep your blood sugar level steady and help you manage your weight. Ask your care team provider about the best activity plan for you. Use caution when you exercise if you have decreased feeling in your feet.
• Maintain a healthy weight. Ask your care team provider what a healthy weight is for you. A healthy weight can help you manage your blood sugar level.

Treatment options

The following list of medications are related to or used in the treatment of this condition.

• Tresiba
• Humalog
• Lantus
• Novolog
• metformin

How to help prevent DN:

• Check your blood pressure as directed. High blood pressure can damage the nerves in your legs, feet, arms, or hands. This can increase your risk for DN or make your DN symptoms worse. A normal blood pressure is 119/79 or lower. Talk to your healthcare provider about your blood pressure goals. Together you can create a plan to lower your blood pressure if needed and keep it in a healthy range. The plan may include lifestyle changes or medicines to lower your blood pressure.
• Talk to your healthcare provider about your cholesterol level. Lab tests are used to measure the amount of cholesterol in your blood. High cholesterol can increase your risk for DN or make you DN symptoms worse. Your provider can help you create a plan to lower your cholesterol level if needed. You may need to make lifestyle changes or take medicines to control your cholesterol level.
• Do not smoke. Nicotine can worsen your symptoms and make it more difficult to manage your diabetes. Ask your healthcare provider for information if you currently smoke and need help to quit. E-cigarettes or smokeless tobacco still contain nicotine. Talk to your healthcare provider before you use these products.
• Limit alcohol as directed. Alcohol can cause your blood sugar levels to be low if you use insulin. Alcohol can cause high blood sugar levels and weight gain if you drink too much. A drink of alcohol is 12 ounces of beer, 5 ounces of wine, or 1½ ounces of liquor. Your healthcare provider can tell you how many drinks are okay to have within 24 hours and within 1 week.

Follow up with your diabetes care team provider as directed:

You will need to have your feet checked at least 1 time each year. Write down your questions so you remember to ask them during your visits.

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