Diabetic Neuropathy Care Guide | Manage Nerve Pain & Prevent Damage

Understanding Diabetic Neuropathy

Diabetic neuropathy is nerve damage caused by high blood sugar over time. It's one of the most common complications of diabetes, affecting up to 50% of people with diabetes.

Types of Diabetic Neuropathy

Type	Area Affected	Prevalence
Peripheral	Feet, legs, hands, arms	Most common
Autonomic	Digestive, urinary, cardiovascular systems	Common
Proximal	Hips, thighs, buttocks	Less common
Focal	Single nerve (face, torso, leg)	Less common

Peripheral Neuropathy

Symptoms

Early signs:

Numbness or tingling in toes or fingers
Burning or shooting pain
Increased sensitivity to touch
Feeling like wearing invisible socks/gloves

Progressive symptoms:

Pain that worsens at night
Muscle weakness
Loss of balance and coordination
Complete loss of sensation

The Danger of Numbness

When you can't feel your feet properly:

Injuries go unnoticed
Small wounds become infected
Ulcers can develop
Risk of amputation increases

Pain Management

Medications

First-line treatments:

Medication	Type	Notes
Gabapentin	Anticonvulsant	Start low, increase gradually
Pregabalin	Anticonvulsant	May work faster than gabapentin
Duloxetine	Antidepressant	Also helps with depression

Topical options:

Capsaicin cream (derived from chili peppers)
Lidocaine patches
Prescription creams

Important: Opioids are generally not recommended due to limited effectiveness and addiction risk.

Non-Drug Approaches

Physical therapy: Improve strength and balance
Transcutaneous electrical nerve stimulation (TENS): May reduce pain signals
Acupuncture: Some find relief with regular sessions
Relaxation techniques: Stress can worsen pain perception

Foot Care: Critical for Neuropathy

Daily Inspection

Check your feet every day for:

Cuts, scrapes, or blisters
Redness or swelling
Changes in skin color
Ingrown toenails
Calluses or corns

Use a mirror or ask someone to help check the bottoms of your feet.

Daily Care Routine

Wash feet with lukewarm water (test with elbow first)
Dry thoroughly, especially between toes
Moisturize dry areas (not between toes)
Inspect for any changes
Wear clean, dry socks

Footwear Essentials

Choose shoes that fit well with adequate toe room
Break in new shoes gradually
Consider custom orthotics if recommended
Never go barefoot, even indoors
Check inside shoes before wearing

When to See a Podiatrist

Any wound that doesn't heal in a few days
Signs of infection (redness, warmth, drainage)
Ingrown toenails
Changes in foot shape
Any unusual symptoms

Prevention Strategies

Blood Sugar Control

The most important prevention strategy:

A1C Level	Neuropathy Risk
Below 7%	Lowest risk
7-8%	Moderate risk
Above 8%	High risk

Every 1% drop in A1C reduces neuropathy risk by about 25%.

Lifestyle Factors

Do:

Exercise regularly (improves circulation)
Eat a balanced diet
Maintain healthy weight
Get regular check-ups

Avoid:

Smoking (reduces circulation)
Excessive alcohol (damages nerves)
Going barefoot
Hot baths (can burn numb feet)

Autonomic Neuropathy

This type affects involuntary body functions.

Symptoms

Digestive:

Nausea, bloating
Constipation or diarrhea
Difficulty swallowing

Cardiovascular:

Dizziness when standing
Rapid heartbeat
Exercise intolerance

Urinary:

Frequent urinary tract infections
Bladder control issues
Incomplete bladder emptying

Sexual:

Erectile dysfunction
Decreased arousal

Management

Work with specialists for each affected system
Medications can help specific symptoms
Blood sugar control remains crucial
Regular screenings catch problems early

When to Seek Immediate Help

Go to the emergency room if:

You have a foot wound with signs of infection
You experience sudden severe pain
You have chest pain or irregular heartbeat
You faint or feel extremely dizzy

Diabetic neuropathy requires ongoing attention, but with proper management, you can prevent complications and maintain quality of life. Work closely with your healthcare team and never ignore changes in sensation or foot problems.