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Diabetic Peripheral Neuropathy


What is diabetic peripheral neuropathy (DPN)?

DPN is damage to the nerves in your arms, hands, legs, and feet. DPN is most common in the legs and feet and can increase your risk for foot ulcers. Nerve pain caused by DPN can limit your mobility, and affect your quality of life.

What increases my risk for DPN?

  • Poor blood sugar control
  • High blood pressure, high cholesterol, or lack of vitamin D
  • Tobacco use

What are the signs and symptoms of DPN?

You may have no symptoms at all. You may have any of the following:

  • Increased sensitivity to touch
  • Muscle weakness or problems balancing or walking
  • Burning, tingling, cramping, or pain in your feet or hands
  • Not able to feel hot, cold, or pressure due to loss of protective sensation (LOPS)
  • Decreased muscle and fat around your feet
  • Decreased movement of your ankles
  • Foot redness, warmth, or calluses

How is DPN diagnosed and treated?

Your diabetes care team provider will check your reflexes, strength, and flexibility. A 10-g monofilament test will be done. A monofilament is a device with one flexible strand that will touch the soles of your feet. Your care team provider may also do a pinprick, temperature, or vibration sensation test. Controlled blood sugar levels is the only treatment for DPN. Controlled blood sugar levels cannot reverse nerve damage. You may be able to prevent or delay DPN, if you have type 1 diabetes. If you have type 2 diabetes, controlled blood sugar levels may slow the progression. Your care team provider may give medicines to help with the nerve pain.

How can I control my blood sugar levels?

Keep your blood sugar levels as close to normal as possible by taking your medicines as directed. Check your blood sugar levels as often as directed. Contact your healthcare provider if your levels are higher than they should be.

How to check your blood sugar
  • Follow the meal plan that your care team provider or dietitian gave you. This meal plan can help you control your blood sugar and decrease your symptoms.
  • Be physically active. Physical activity, such as exercise, can help keep your blood sugar level steady and help you manage your weight. Be active for at least 30 minutes, 5 days a week. Ask your care team provider about the best activity plan for you. Use caution when you exercise if you have decreased feeling in your feet.
  • Maintain a healthy weight. Ask your care team provider how much you should weigh. A healthy weight can help you control your diabetes. Ask him to help you create a weight loss plan if you are overweight. Even a 10 to 15 pound weight loss can help you manage your blood sugar level.
  • Know the risks if you choose to drink alcohol. Alcohol can make it harder to manage diabetes. Alcohol can cause your blood sugar levels to be low if you use insulin. Alcohol can cause high blood sugar levels and weight gain if you drink too much. Women 21 years or older and men 65 years or older should limit alcohol to 1 drink a day. Men aged 21 to 64 years should limit alcohol to 2 drinks a day. A drink of alcohol is 12 ounces of beer, 5 ounces of wine, or 1½ ounces of liquor.

What else can I do to prevent or manage DPN?

  • Care for your feet. Check your feet each day for cuts, scratches, calluses, or other wounds. Look for redness and swelling, and feel for warmth. Wear shoes that fit well. Check your shoes for rocks or other objects that can hurt your feet. Do not walk barefoot or wear shoes without socks. Wear cotton socks to help keep your feet dry.
  • Do not smoke. Nicotine can worsen your symptoms and make it more difficult to manage your diabetes. Do not use e-cigarettes or smokeless tobacco in place of cigarettes or to help you quit. They still contain nicotine. Ask your care team provider for information if you currently smoke and need help quitting.

When should I seek immediate care?

  • Your legs or feet start to turn blue or black.
  • You have a wound that does not heal or is red, swollen, or draining fluid.

When should I call my care team provider?

  • You begin to have symptoms.
  • Your blood sugar level is higher or lower than care team providers have told you it should be.
  • You have redness, calluses, or sores on your feet.
  • You have questions or concerns about your condition or care.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your healthcare providers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.