Early detection of diabetes and tight control of blood sugar levels may reduce the risk of developing diabetic neuropathy.
Treatments for diabetic neuropathy includes 3 main components.
●Tight control of blood sugar levels
●Care for the feet to prevent complications
●Control of pain caused by neuropathy
Although there is no cure for diabetic neuropathy, use of these treatments can improve painful symptoms and prevent complications.
Control blood sugar levels — One of the most important treatments for diabetic neuropathy is to control blood sugar levels. Symptoms of pain and burning may improve when blood glucose sugar improves. If blood sugar levels are not adequately controlled with the current treatment regimen, a different regimen may be recommended.
●For people with type 1 diabetes, this may mean taking more frequent insulin injections or using an insulin pump.
●For people with type 2 diabetes, this may mean taking an additional oral medication or starting insulin injections.
Take Care of your feet — People with neuropathy do not always feel pain when there is a wound or injury on the foot. As a result, daily foot care is necessary to monitor for changes in the skin (such as cracks or wounds), which can increase the risk of infection. The American Diabetes Association recommends that people with diabetes have a comprehensive foot examination once per year, and a visual examination of the feet at each visit (usually every three to four months).
Avoid activities that can injure the feet — Some activities increase the risk of foot injury and are not recommended, including walking barefoot, using a heating pad or hot water bottle on the feet, and stepping into the bathtub before testing the temperature with the hand.
Use care when trimming the nails — Trim the toe nails along the shape of the toe (rounded, not straight across) and file the nails to remove any sharp edges. Never cut (or allow a manicurist to cut) the cuticles. Do not pop blisters, try to free ingrown toenails, or otherwise break the skin on the feet. See a healthcare provider or podiatrist for even minor procedures.
Wash and check the feet daily — Use lukewarm water and mild soap to clean the feet. Gently pat feet dry and apply a moisturizing cream or lotion.
Check the entire surface of both feet for skin breaks, blisters, swelling, or redness, including between and underneath the toes where damage may be hidden. Use a mirror or ask a family member or caregiver to help if it is difficult to see the entire foot.
Choose socks and shoes carefully — Select cotton socks that fit loosely and change the socks every day. Wear shoes that are fit correctly and are not tight. Ask about customized shoes if your feet have ulcers; specialized shoes can reduce the chances of developing foot ulcers in the future. Shoe inserts may also help cushion the step and decrease pressure on the soles of the feet.
Ask for foot exams — Screening for foot complications should be a routine part of most medical visits, but is sometimes overlooked. At each visit, the shoes and socks should be removed and the clinician should visually examine the feet. Do not hesitate to ask the healthcare provider for a complete foot check at least once a year, and more frequently if there are problems.
Control pain — Neuropathic pain can be difficult to control and can seriously affect your quality of life. Neuropathic pain is often worse at night, seriously disrupting sleep.
Fortunately, only a small percentage of people with diabetic neuropathy experience pain. Pain resolves without treatment in some people over a period of weeks to months.
In other patients who have severe neuropathic pain, the neurologists can select a medicine from several medications which are available for the treatment of diabetic neuropathy.
*Reference: Eva L.Feldman MD. Patient education: Diabetic neuropathy. Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc.