Diabetic neuropathy refers to nerve damage due to diabetes. When it affects the feet, healthcare professionals call it peripheral neuropathy. It usually affects both feet at the same time, as well as the hands, arms, and legs.
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When a person has high blood sugar (glucose) and high triglycerides in the blood over a long period, it damages the nerves and small blood vessels that serve the nerves. This can lead to
- tingling in the feet, legs, arms, or hands
- numbness
- burning, stabbing, or shooting sensations
- pain
- weakness
- skin sensitivity
- problems sensing pain or temperature in the affected areas
- feet and hands that feel hot or cold
- open sores on the feet and hands
Symptoms may worsen at night and usually affect both sides of the body. These symptoms can lead to problems such as:
- walking difficulties
- balance issues
- loss of muscle tone in the feet and hands
- swelling in the feet and hands
- difficulty sensing position and movement of the feet and hands
Diabetic peripheral neuropathy may begin with sensations in the feet but lead to skin breakdown, infection, ulcers, and ultimately, amputation.
People with diabetes must have an annual foot exam to check for neuropathy, while those with neuropathy need more frequent foot exams.
A healthcare professional will check the skin, muscles, bones, and blood flow in the feet. They may use a fine tool called a monofilament, or a tuning fork, to check the nerve sensation in the feet. Nerve conduction studies check how efficiently the nerves send messages, while electromyography shows how the nerves and muscles work together.
Once nerve damage occurs, there are no treatments to reverse it. However, keeping blood glucose levels within the target range may slow its progression and prevent it from occurring.
Weight-bearing exercise, such as walking, physical therapy, and massage can help
A doctor may prescribe medications to relieve pain and other symptoms. Counseling or medications to help with the mental effects of neuropathy may also help.
Certain lifestyle choices, such as eating a nutritious diet, being physically active, and getting plenty of sleep, can help slow the progression of diabetic neuropathy. It is also important to maintain a moderate weight, limit alcohol consumption, and quit smoking, if applicable.
The American Diabetes Association gives the following recommendations for people with neuropathy in the feet:
- Avoid walking barefoot indoors or outdoors.
- Wear supportive, well-fitting shoes and socks.
- Check shoes daily for objects inside or stuck in the sole and for signs of wear and tear.
- Avoid using corn plasters and wart removal medication.
- Do not soak the feet in water or use Epsom salt.
- Before showering, check the water temperature with an elbow or thermometer.
- Inspect the feet daily for changes, such as swelling, discoloration, and wounds.
- Moisturize the skin of the feet, avoiding between the toes.
If a person with diabetes notices any changes in their feet, legs, arms, or hands, they must discuss them with a doctor.
