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How to prevent complications from DPN
While there is no cure, there are many ways to prevent or delay nerve damage, including proper foot care and being mindful of anything that could make you prone to developing an infection or sore.
You’re more likely to have foot problems with diabetes because it can damage your nerves and lessen blood flow to your feet. Nerve damage prevents your feet and legs from feeling temperature or pain and poor blood circulation prevents small cuts or sores from healing well.
Diabetes can also dry the skin on your feet and make your heels crack. The big risk is infection. Germs or fungus can get into small cuts or cracks. If you think you’ve gotten an infection, tell your doctor right away. Early treatment can keep it from spreading. Here are some self-care behaviors to prioritize:
- Keep your feet clean, but don’t soak them for a long time. Use mild soap and warm water.
- Pat your skin dry; do not rub. Thoroughly dry your feet.
- Apply lotion if your feet are dry (but not between the toes).
- Examine your feet and legs daily, use good light so you can spot any problems.
- Check for dry, cracked skin, blisters, cuts, scratches, bruises, scrapes or other sores on your feet, toes, and heels.
- Check between your toes for cuts or fungus that might cause athlete’s foot.
- Care for your nails regularly, check for ingrown toenails, corns and calluses.
- Wear properly fitting footwear that promotes good circulation, cushions and protects the feet. Get special shoes if needed
- Choose socks that are thick and soft with no seams, as they could cause blisters.
- Test your bathwater before you step in to make sure it’s not too hot.
- If you are prone to foot swelling, wear compression socks and prop up your feet as often as possible.
- Be careful with exercising. Some physical activities are not safe for people with neuropathy. Talk with a diabetes clinical exercise expert who can guide you.
- As mentioned above, managing your blood glucose levels effectively can help to prevent further nerve damage.
Psychological side effects:
DPN can markedly impair both physical and psychological functioning and quality of life. DPN remains challenging to treat adequately, especially if very painful. The number of people with DPN achieving adequate pain reduction remains low and depression in individuals with chronic DPN can hamper self-care and increase the risk of adverse outcomes.
One-third of those with DPN often experience debilitating neuropathic pain symptoms which can result in:
- postural instability (poor balance due to loss of sensory perception)
- foot complications and their psychological impact, including:
- depression, anxiety, poor sleep quality and sometimes severe sleep deprivation
- fear of falling
- fear of amputation
- negative impact on self-care tasks
- decreased work productivity and even loss of employment or early retirement
People suffering from DPN benefit from regular screening and monitoring of their DPN symptoms combined with assessments of associated psychological problems.
Treatment
DPN has no known cure but there are some successful treatments. While keeping blood glucose levels in goal range can prevent peripheral neuropathy and keep it from getting worse, there aren’t any medications that can reliably reverse nerve disease once it’s established. DPN remains challenging to treat but there are options to explore.
Once neuropathy is detected, the focus is on keeping the feet and legs healthy and on managing pain, diabetes glucose goals and optimizing lifestyles. The goals of treatment are to:
- Slow progression
- Relieve pain
- Manage complications and restore function
Conventional analgesics and pain relievers (such as aspirin, Tylenol, nonsteroidal anti-inflammatory drugs, paracetamol, and weak opioids such as codeine) and many prescription medications are often not adequate to relieve pain and may cause side effects.
Talk to your health care provider about the benefits and possible side effects of treatment to find what might work best for you.
There are also several unique implantable technologies using direct subcutaneous nerve stimulation devices to reduce DPN. Pain specialists can discuss these with patients.
HOPE FOR IMPROVED PATIENT OUTCOMES IN THE FUTURE
With the cooperation of patients with DPN and the continued research of clinical scientists, biochemical engineers, pharmacists, clinical research physicians and staff, we will someday have safe AND effective therapies to reduce the burden of this difficult diabetic complication.
Sources:
Diabetic neuropathy: Symptoms and Causes - Mayo Clinic
Diabetic neuropathy: Diagnosis and Treatment - Mayo Clinic
Peripheral Neuropathy - American Diabetes Association
Diabetes Foot Care - WebMD
Diabetes Care - Psychological Care for People with Diabetic Peripheral Neuropathy - American Diabetes Association
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