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    Mayo Clinic Q and A: Diabetes and risk of peripheral neuropathy

a medical illustration of peripheral neuropathyDEAR MAYO CLINIC: I was diagnosed with diabetes a few months ago, and I am concerned about peripheral neuropathy in my feet. Is there anything I can do to prevent this?

ANSWER: Peripheral neuropathy is a common problem that can happen as a result of diabetes. But it isn’t inevitable. To help prevent peripheral neuropathy, closely follow your health care provider’s instructions for managing your diabetes and make healthy lifestyle choices.

Peripheral neuropathy happens when nerves in your feet or hands — your peripheral nerves — become damaged. Diabetes may lead to peripheral neuropathy because excess sugar in the blood can injure the walls of the tiny blood vessels, called capillaries, which deliver blood to the nerves. That injury hampers the capillaries’ ability to carry sufficient amounts of blood. Without proper nourishment, the peripheral nerves lose their ability to function properly.

Although peripheral neuropathy can affect both the hands and the feet, for people with diabetes, it’s more common in the feet. It usually involves a slow progression of numbness, prickling or tingling in the feet that may then spread into the legs. Some people with peripheral neuropathy also feel a sharp, jabbing, throbbing, freezing or burning pain, and their feet may be extremely sensitive to touch.

The best thing you can do to help prevent peripheral neuropathy is keep your blood sugar under control. Monitor your blood sugar regularly, and take your diabetes medications exactly as directed by your health care provider.

Exercising regularly also can help control your blood sugar and help prevent peripheral neuropathy. Try to make physical activity part of your daily routine. Thirty minutes of moderate exercise, such as brisk walking, on most days of the week is recommended. A combination of exercises — aerobic exercises, such as walking, biking or swimming on most days, combined with resistance training, such as weightlifting or yoga twice a week — often helps control blood sugar more effectively than either type of exercise alone.

A healthy diet is important, too. Eat plenty of fruits, vegetables, whole grains and legumes each day, and limit the amount of food you eat that contains saturated fat. If you have questions about your diet, talk to your health care provider, or consider meeting with a dietitian who specializes in working with people who have diabetes.

Exercise and diet also can help if you need to lose weight. If you’re overweight, getting to and staying at a healthy body weight can lower your blood sugar significantly, thus reducing your risk of peripheral neuropathy.

If you smoke, stop. Smoking can affect your blood circulation and raise your risk of developing peripheral neuropathy. If you're having trouble quitting on your own, ask your health care provider about smoking cessation options, including medications to help you quit.

Because peripheral neuropathy can sometimes begin slowly with just numbness in the feet, it’s important that you are vigilant about foot care. Check your feet daily for any cuts or other injuries. Left unchecked, a small injury can turn into a major infection. To avoid foot damage, be careful when you trim your toenails, wear shoes that fit properly and don’t go barefoot.

If you notice any foot injuries or sores on your feet that do not heal, make an appointment with your health care provider to have them checked as soon as possible. Also, talk to your health care provider right away if you notice any foot numbness or pain. Early diagnosis and treatment of peripheral neuropathy offer the best chance for controlling its symptoms and preventing further damage to your nerves. — Dr. Elizabeth Cozine, Family Medicine, Mayo Clinic Health System, Zumbrota, Minnesota 

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