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Prevention
By Mayo Clinic staffYou can help prevent or delay diabetic neuropathy and its complications by keeping your blood sugar consistently well controlled, taking good care of your feet and following a healthy lifestyle.
Blood sugar control
Keeping your blood sugar tightly controlled every day is a big commitment. It requires constant monitoring and, if you take insulin, frequent doses of medication. But keeping your blood sugar as close to normal as possible is the best way to help prevent neuropathy and other complications of diabetes. Consistency is important because shifts in blood sugar levels can accelerate nerve damage.
For the best control, aim for a blood glucose level from 90 to 130 mg/dL (5 to 7 mmol/L) before meals and an A1C reading that is less than 7 percent. An A1C test measures your average blood sugar level over a period of two to three months. The American Diabetes Association recommends that people with diabetes have an A1C test at least twice a year if blood sugar levels are consistently in a healthy range. If your blood sugar isn't well controlled or you change medications, you should be tested more often.
Foot care
Foot problems, including sores that don't heal, ulcers and even amputation, are the most common complication of diabetic neuropathy. But many of these problems can be prevented by having a comprehensive foot exam at least once a year, having your doctor check your feet at each office visit and taking good care of your feet at home.
To protect the health of your feet:
- Check your feet every day. If you can't see some parts of your feet, use a mirror or ask a family member or friend to examine those areas. Look for blisters, cuts, bruises, cracked and peeling skin, and redness and swelling.
- Keep your feet clean and dry. Wash your feet every day with lukewarm water. If your feet can't sense temperature, test the water by touching a dampened washcloth to a sensitive part of your body, such as your neck or wrist. Dry your feet gently by blotting or patting. Rubbing may damage your skin. Dry carefully between your toes. Then moisturize your skin thoroughly to prevent cracking.
- Trim your toenails carefully. Cut your toenails straight across, and file the edges carefully. If you're not able to reach your feet, ask a family member, your doctor or a podiatrist to help you.
- Wear clean, dry socks. You don't need to buy special socks for people with diabetes, but do look for socks made of cotton or moisture-wicking fibers that don't have tight bands or thick seams.
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Wear shoes that fit well. Always wear shoes to protect your feet from injury. Make sure that your shoes fit properly. It's best to try on shoes later in the day when your feet are more swollen to ensure that the shoes aren't too tight. A podiatrist can teach you how to buy properly fitted shoes and to prevent problems such as corns and calluses.
If problems do occur, a podiatrist can help treat them to prevent more-serious conditions from developing. Even small sores can quickly turn into severe infections if left untreated. Shoes that fit well can be costly.
If you qualify for Medicare, your plan may cover the cost of at least one pair of shoes a year. For more information, talk to your doctor or diabetes educator.
Lifestyle choices
These measures also can help reduce your risk of diabetic neuropathy:
- Keep your blood pressure under control. People with diabetes are about twice as likely to have high blood pressure as people who don't have diabetes. Having both high blood pressure and diabetes greatly increases your risk of complications because both damage your blood vessels and reduce blood flow. Try to keep your blood pressure in the range your healthcare provider recommends, and be sure to have it checked at every office visit. Also consider checking it regularly at home.
- Make healthy food choices. Eat a balanced diet that includes a variety of healthy foods — especially fruits, vegetables and whole grains — and limit portion sizes to help achieve or maintain a healthy weight.
- Be active every day. In addition to helping you achieve a healthy weight, daily activity protects your heart and improves blood flow. It also plays a major role in keeping your blood sugar and blood pressure under control.
- Stop smoking. If you have diabetes and use tobacco in any form, you're more than twice as likely as nonsmokers with diabetes to die of heart attack and stroke. And you're more likely to develop circulation problems in your feet. If you use tobacco, talk to your doctor about ways to quit.
