If you have diabetes and peripheral neuropathy, it's critical that you carefully control your blood sugar levels. High blood sugar levels over time damage 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.
Adopting healthy eating and exercise habits is "tremendously important," because it keeps blood sugar levels under control, says Tom Elasy, MD, MPH, who holds the Ann and Roscoe R. Robinson Chair of Clinical Research at the Diabetes Center at Vanderbilt University in Nashville.
For most people, a bad shoe day means a blistered heel or painful arch that goes away quickly. But for people with diabetes, poor footwear can trigger serious problems, such as foot ulcers, infections, and even amputation.
Foot problems aren't inevitable, though. Ralph Guanci learned the hard way to pick his shoes with care and to stick with wearing them because they're good medicine for his feet.
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"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 and help peripheral neuropathy:
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. Your doctor can get you started on an exercise program that won't be hard on your feet – such as walking, swimming, biking, or yoga. You may need to limit exercises that are hard on 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 foot.
If you smoke, stop. Smoking makes circulatory problems worse, and it worsens the symptoms of peripheral neuropathy. It 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 drug therapy such as nicotine patches, gum, prescription medication, or other aides. Antidepressants can also help reduce cravings and help control pain from neuropathy at the same time.
Carefully limit alcohol. Alcohol can worsen peripheral neuropathy and make it hard to control your blood sugar levels.
Diet and Peripheral Neuropathy
To keep blood sugar under control, 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, and what to avoid.
You will need to keep close track of the carbohydrates you eat, because they have the most immediate effect on your blood sugar. Carbohydrates are found in:
Milk, yogurt, and other dairy products
Candy, cake, cookies, ice cream (desserts)
Processed foods (most have sweeteners)
You should eat plenty of fiber, because it plays a role in the digestive process and delays sugar absorption. Choose from:
Fresh fruits and vegetables
Cooked dried beans and peas
Whole-grain breads, cereals, and crackers
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, and yogurt
Low-fat vegetable cooking spray
Low-fat margarines and salad dressings
Avoid high-salt foods, which can cause high blood pressure:
Boxed mixes of potatoes, rice, pasta
Canned soups and vegetables
Processed and packaged foods (lunch meat, sausage, bacon, ham)
Tom Elasy, MD, MPH, director of the Division of General Internal Medicine and Public Health, associate professor of medicine, and Ann and Roscoe R. Robinson Chair of Clinical Research at the Diabetes Center, Vanderbilt University, Nashville, Tenn. WebMD: "Diabetes: Eating Right."
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