Guide: Peripheral Neuropathy and Diabetes

If you have diabetes and peripheral neuropathy, it's critical that you carefully control your blood sugar levels. High blood sugar over time damages the blood vessels and nerves in your legs and feet. Fortunately, a good diet and regular, moderate intensity exercise can help improve your body's use of insulin, get your weight under control, and improve blood sugar.

Adopting healthy eating and exercise habits is "tremendously important" because it keeps blood glucose (blood sugar) levels under control, says Tom Elasy, MD, director of the Diabetes Clinic at Vanderbilt University in Nashville, Tenn.

"There is considerable scientific evidence that lifestyle changes can prevent the development and slow the progression of neuropathy," he says. "In addition, exercise like walking can relieve the pain, probably because it improves circulation."

To change your lifestyle:

• Get regular physical activity. Ask your doctor for an exercise routine that is right for you. Aside from helping you reach and maintain a healthy weight, exercise also improves the body's use of insulin and improves circulation. It also strengthens muscles, which improves coordination and balance in muscles that may have been weakened due to decreased nerve activity. Your doctor can get you started on an exercise program that won't be hard on your feet -- like walking, swimming, biking, or yoga. You may need to limit exercises that do stress your feet, such as running or aerobics. People with neuropathy -- especially those with bone deformities -- should always wear well-fitted shoes to avoid pressure sores and ulcers on the feet.
• If you smoke, stop. Smoking makes circulatory problems worse, which is thought to be one cause of neuropathy, and worsen the symptoms of peripheral neuropathy. Smoking also greatly increases the risk of heart disease in people with diabetes. Talk to your doctor about ways to quit smoking. Often, people turn to counseling and to drug therapy, such as nicotine patches, gum, or other aides. Antidepressants can help reduce cravings and help control pain from neuropathy at the same time.
• Carefully limit alcohol. Excess alcohol intake can worsen neuropathy and make it hard to control your blood sugar levels.

Eat a Balanced Diet

To keep blood sugar as close to normal as possible, it's important to follow the right meal plan. A well-balanced diet can make a big difference. You might want to consult with your doctor or a dietitian to learn what foods are best, when to eat, how much to have of each food, and what to avoid.

You will need to keep close track of the carbohydrates you eat since they have the most immediate effect on your blood sugar. Carbohydrates are in these food groups:

• Fruit
• Milk and yogurt
• Bread, cereal, rice, pasta
• Starchy vegetables

You should eat plenty of fiber since it plays a role in the digestive process, reduces heart disease risk, and can improve blood sugars. Choose from:

• Fresh fruits and vegetables
• Cooked dried beans and peas
• Whole grain breads, cereals, and crackers
• Brown rice
• Bran products

It's important to eat foods that are low in fat. Good choices are:

• Lean meats. Bake, broil, grill, roast, or boil - never fry
• Low-fat dairy. That includes cheese milk, yogurt
• Low-fat vegetable cooking spray
• Low-fat margarines and salad dressings

Avoid high-sodium foods, which can cause high blood pressure:

• Salt
• Boxed mixes of potatoes, rice, pasta
• Canned meats
• Canned soups and vegetables
• Processed and packaged foods (lunch meat, sausage, bacon ham)
• Salty snack foods

SOURCES: Tom Elasy, MD, director, Diabetes Clinic, Vanderbilt University, Nashville, Tenn. WebMD Medical Reference provided in collaboration with The Cleveland Clinic: "Diabetes: Eating Right."