Living with Diabetes

Diabetes Getting On Your Nerves?

Nerves are the messengers of the body. They provide your brain with information about pain, temperature and touch. They talk to your muscles and tell them how and when to move and they control body systems that digest food, pass urine and they control erections. Over time excess glucose can injure the walls of the tiny blood vessels that nourish your nerves, especially in the legs. This can cause tingling, numbness, burning or pain that usually begins at the tips of the toes or fingers and over a period of months or years gradually spreads upward. About half of all people with diabetes have some form of nerve damage. It is more common in those who have had the disease for a number of years. Nerve damage from diabetes is called diabetic neuropathy.

Take the following steps to prevent or delay nerve damage:

• Meal planning, physical activity and medications, if needed, all can help you reach your average glucose target range.
• Track your blood glucose levels. Use a blood glucose meter to help you make decisions about day-to-day care. Get an A1C test at least twice a year to find out your average blood glucose for the past 2-to-3 months.
• Report any possible signs of diabetic neuropathy, such as pain or numbness in your feet. It is especially important to report any sore or break in the skin of your feet.
• If you have problems, get treatment right away. Early treatment can help prevent more problems later on. For example, if you take care of a foot infection early, it can help prevent amputation.
• Take good care of your feet. Check your feet every day. If you no longer can feel pain in your feet, you might not notice a foot injury. Instead, use your eyes to look for problems. Use your hands to feel for hot or cold spots, bumps or dry skin. Look for sores, cuts or breaks in the skin. Also check for corns, calluses, blisters, red areas, swelling, ingrown toenails and toenail infections.
• Protect your feet. If your feet are dry, use a lotion on your skin but not between your toes. Wear shoes and socks that fit well and wear them indoors and out. Use warm water to wash your feet, and dry them carefully afterward.
• Get special shoes if needed. If you have foot problems, Medicare or other insurance may pay for shoes. Ask your health care team about it.
• If you have diabetic neuropathy, talk to a diabetes clinical exercise expert who can guide you, as some physical activities are not safe for people with neuropathy.
• Make sure your health care provider checks your feet at every visit.