Self-Management Tips for Living with Diabetic Peripheral Neuropathy
By Grayson Schultz
Living with diabetes is complex, particularly when also dealing with diabetic peripheral neuropathy (DPN). Patients find that effectively managing these conditions starts with them—which is why self-management tools are so vital.
Self-management is an important part of whole-person care, and that looks different for every individual. Trial and error is key to figuring out what helps you the most.
“Some therapeutic approaches can be very effective for some people but less so, or not at all, for others,” explains Kevin Peterson, MD, MPH, vice president of primary care with the American Diabetes Association. “It is never too early to seek professional guidance about adjusting self-management approaches.”
Monitoring diet and tracking blood sugar levels
Managing blood sugar levels, or A1C, is a major part of treating diabetes, in part because high blood sugar can lead to nerve pain and damage.
“Persistently high blood sugar levels can damage the small blood vessels that feed the nerves,” Peterson explains. “When these small blood vessels become blocked, the nerves lose their blood supply and the nerve fibers begin to die. This is usually noticed first in the longest nerves in the body, which are the ones that go to the feet and toes.”
There is no one-size-fits-all way to keep blood sugar levels low. Working with a Certified Diabetes Care and Education Specialist (CDCES) is one way to build a personalized plan to keep blood sugar low that incorporates self-management strategies.
Sylvia Ann Faircloth, who has lived with diabetes for more than two decades, has found this type of monitoring to be effective in managing her pain. She grew up in a home where sweets were always around, especially during the holidays. While observing her own symptoms, she noticed that sweets would trigger her neuropathy pain. After speaking with her doctor and learning that her A1C levels could be increasing her nerve pain, she became more diligent in monitoring her sugar intake. Today, her pain is at more manageable levels.
Foot care
One of the most vital things you can do to manage DPN is to pay more attention to your feet. In addition to undergoing regular foot exams with a podiatrist, there are important steps that you should take at home.
Wash your feet daily, ensure they dry completely, and use a moisturizing cream. Massaging your feet regularly can help with blood flow.
Faircloth always wears shoes around the house, which helps protect against injuries. It also means her feet aren’t as cold, saving her from additional pain.
Improving sleep
Diabetic nerve pain often increases at night. To combat this, Faircloth takes a warm shower before bed and uses topical menthol treatments on her feet and legs. She also tries to stay as warm as possible, listens to recordings of nature sounds, and repeats soothing mantras to help her fall asleep. Still, Faircloth’s pain is sometimes severe enough that she can’t sleep at all.
Managing nighttime pain and improving sleep is an important part of overall pain self-management, Peterson notes.
“Without adequate pain control, sleep can regularly be interrupted,” he explains. The providers treating your diabetes can help you develop a personalized at-home strategy to improve pain and sleep at night.
Diet, exercise, and stress management
A diet and exercise routine that takes diabetes into account and is tailored to the individual is an important step in self-management of DPN. Maintaining these routines can improve blood sugar levels, which can help prevent nerve damage, Peterson says. Avoiding smoking is also important for the health of blood vessels and nerves.
Stress management is key as well. Stress itself doesn’t cause nerve pain, but it can make it worse. Stress can “decrease a person’s ability to effectively participate in prevention activities, successfully manage blood sugar, and effectively cope with pain,” Peterson explains.
Many things can reduce stress, including mindfulness, exercise, deep breathing, creating art or music, and spending time outside. Spending time with the people and pets you care about the most are known stress relievers, too. If you’re finding it hard to manage stress, consider reaching out to a mental health provider.
Building a personalized plan
Finding the self-management techniques that work for you may take some time.
“Don’t give up,” Peterson says. “It may take a while, but most people are eventually able to find an effective treatment. Learn as much as you can about self-management, and then gather your professional help. Diabetes and DPN can be a lifelong journey.”
Before utilizing self-management strategies for DPN, it’s important to see a medical professional for proper diagnosis. Faircloth has lived with type 2 diabetes and DPN for years, but her nerve pain began long before her DPN diagnosis. She urges everyone living with diabetes to have their nerve function and sensation checked regularly, particularly if they are experiencing pain.
Additionally, while self-management strategies can be implemented at home, it’s a good idea to discuss them with the medical professionals working with you to manage your diabetes.
Self-management has been an important tool for Faircloth as she has learned to live with diabetes and the pain it causes.
“Take care of yourself,” she says. “Not just your feet, your legs, your hands, but your whole self. That’s the bottom line.”
BUILD YOUR SELF-MANAGEMENT PLAN
Learn more about self-management strategies for pain and build a personalized plan by visiting uspainfoundation.org/pain/selfmanage