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7 Teaching Tips for Patients with Diabetic Neuropathy

Posted by Melissa Cott on Oct 30, 2023

Adapted from Dr. Axe: Diabetes affects about one in every three adults in the U.S., and diabetic neuropathy is one of the most likely complications to develop as a side effect because high blood sugar levels affect nerve fibers throughout the body. Diabetic neuropathy (also sometimes called peripheral neuropathy) is the term for nerve damage caused by diabetes, a chronic condition that occurs when the body doesn’t use the hormone insulin properly.

 Neuropathy can form anywhere but is most likely to affect nerves running through the limbs, hands and feet.

Just like with diabetes itself, there is no known “cure” for peripheral neuropathy, only ways to manage it and stop progression, similarly to the natural treatments for diabetes.  It’s a dangerous problem to have, but fortunately most people are able to keep it under control by regulating their blood sugar levels, changing their diets and adopting healthier lifestyles overall, all of which help control their diabetes.Download Patient Teaching: Diabetic Foot Care Do's and Don'ts

1. Manage Blood Sugar Levels

Maintaining blood sugar consistently within a healthy range is the most important thing to prevent permanent damage to the nerves, blood vessels, eyes, skin and other body parts before complications develop.

img-diabetic-foot-careStudies have found that poor blood sugar greatly increases risk for peripheral neuropathy, which accounts for hospitalizations more frequently than other complications of diabetes and also is the most frequent cause of non‐traumatic amputations. (2) The best way to do this is through a combination of frequent blood glucose testing, eating a healthy diet, exercising, and working with the patient's doctor to determine if diabetes medicine and/or insulin therapy needs to be adjusted.

2. Follow a Healthy Diet

Teach the patient to eat plenty high-fiber foods that are packed with nutrients but low in sugar/artificial ingredients, including:

    • Cut out most grains if possible, but especially those made with refined wheat flours.
    • vegetables and whole fruits: all kinds, which are high in antioxidants, fiber, vitamins, and essential electrolytes like minerals and potassium
    • Limit intake of high-sodium foods. Keep sodium to no more than 2,300 milligrams per day to help control blood pressure.
    • Drink six to eight eight-ounce glasses of water each day to stay hydrated, plus fill up on more fiber-rich and water-rich foods like fresh veggies and fruit to feel satisfied on less.
    • Watch portions, and try measuring things for a bit to learn proper serving sizes.
    • Encourage the patient to keep track of your food intake in a food journal for several weeks
    • Manage blood sugar by sticking to regular meals and snack times, eating balanced portions every few hours.


3. Exercise and Try Physical Therapy

Exercising regularly is one of the simplest ways to manage diabetes symptoms, help maintain a healthy weight, control blood sugar and high blood pressure symptoms, increase strength, and improve range of motion — in addition to all the other benefits of exercise. A 2012 study published in the Journal of Diabetes Complications found that regular exercise caused significant reductions in pain and neuropathic symptoms in diabetics and increased intraepidermal nerve fiber branching.

Encourage the patient to work his/her way up to exercising for 30–60 minutes daily, doing low-impact exercises like walking, cycling, swimming.

Physical therapy can also be helpful because it increases muscle strength, mobility and daily functioning.

4. Reduce Exposure to Toxins and Quit Smoking

People with neuropathy are more likely to develop kidney stone symptoms and other kidney problems, including kidney disease.

Teach the patient to quit smoking as quickly as possible, since s/he is more likely, than diabetic nonsmokers, to develop nerve damage and even have a heart attack or stroke. 

5. Manage Stress

Stress makes inflammation worse and raises the risk for diabetic complications. Exercising, meditating or practicing healing prayer, spending more time doing hobbies or being in nature, and being around family and friends are all natural stress relievers that should be considered. Acupuncture is another beneficial treatment that not only helps lower stress and pain, but also has been shown to be ease symptoms of neuropathy safely with very few, if any, side effects. 

6. Lower Pain Naturally

Studies have shown that several natural anti-inflammatories and antioxidants help stop nerve damage from progression and lower pain. These include:

      • Alpha lipoic acid: an anti-inflammatory shown to improve insulin sensitivity and defend against neuropathy, take 300–1,200 milligrams daily 
      • Evening primrose oil: an anti-inflammatory that lowers neuropathy numbness, tingling and burning and has other positive effects, take 360 milligrams daily 
      • Chromium picolinate: helps improve insulin sensitivity, take 600 micrograms daily
      • Cinnamon: known to help stabilize blood sugar, add one to two teaspoons to meal daily and try using cinnamon oil
      • Omega-3 fish oil: take 1,000 milligrams daily to help lower inflammation
      • Vitamin B12: many diabetics seem to be low in this nutrient, which can worsen nerve damage
      • Essential oils to help dull pain and lower inflammation, including peppermint, lavender and frankincense

7. Protect Skin and Feet

Foot care and skin care are important parts of treatment and prevention for diabetic neuropathy, according to the American Diabetes Association. Teach the patient to wash skin and feet/toenails carefully daily, especially in skin folds where bacteria and moisture can build up and cause infections.

Teach the patient to wear clean socks and clothing, and keep delicate skin out of the very hot temperatures (such as very warm showers) and the sun. Advise the patient to cut toenails, file corns, and see a doctor if s/he notices redness, swelling or infection forming. Some studies have also found that skin creams containing capsaicin from cayenne pepper can help reduce pain sensations in some people, although use these carefully since it’s possible they can cause burning and skin irritations in some people.

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