Stephen J. Schueler, M.D.

Overview Symptoms Evaluation Treatment questions for doctor specialist Home Care diet self monitoring warning signs Outlook Underlying Cause

Foot Pain due to Diabetes Home Care

Home care for diabetic neuropathy includes:

  • Follow your diabetic diet.
  • Do not drink alcohol.
  • Stop smoking.
  • Avoid exposure to secondary smoke.
  • Follow an exercise plan developed with your doctor.
  • Get regular checkups for your diabetes, including eye and foot exams.
  • Monitor your blood sugar:
    • Check your blood sugar every day.
    • Keep a log of your results.
    • Notify your doctor if your blood sugar remains higher than usual.
  • If you have high blood pressure:
    • Learn how to take your blood pressure.
    • Check your blood pressure every day.
    • Keep a log of your results.
  • Weight loss if you are overweight
  • Take your diabetes medications as directed:
    • Don't skip doses of your medication. This makes them less effective.
    • Avoid running out of your medication. Refill your prescriptions early.
    • Don't stop taking your medication just because you feel better.
    • If you feel worse, talk to your doctor before you stop your medication.
    • Be aware of the common side effects that may be caused by your medication.
    • Do not stop prescription medications without talking to your doctor.
  • Learn everything you can about diabetic neuropathy:
    • The more you know about your condition, the easier it will be to participate with your doctor in making treatment decisions.
    • Ask your doctor about good sources for information.
    • Write down questions to ask your doctor

Example of Sliding Scale Insulin Dosing
Glucose ReadingRegular Insulin Dosing
140 - 1602 units, re-check glucose in 2 hrs
200 - 2404 units, re-check glucose in 2 hrs
240 - 3006 units, re-check glucose in 2 hrs
300 - 4008 units, re-check glucose in 2 hrs
400 - 50010 units, re-check glucose in 2 hrs
> 500See doctor now!

Foot Pain due to Diabetes Diet

It is important to follow a healthy diet if you have diabetic neuropathy.

Total Calories
Your daily intake of calories should allow you to maintain a healthy weight. Total calorie requirements vary according to your weight, height and activity. Your doctor and dietitian will recommend a total daily calorie requirement that is right for you.

Carbohydrates should account for 55-60% of your total calories. Carbohydrates include sugars, starches, and fiber. Whole grains, fruits, vegetables and fiber, are better sources of carbohydrate than sugars. Dietary fiber has been shown to prevent constipation, reduce the risk of colon cancer and reduce cholesterol levels. A healthy diet contains 20-35 grams of fiber per day.

Protein should account for 10-20% of your total calories. Those who have normal kidneys should consume about 50 to 60 grams of protein per day. Those who have kidney disease should consume no more than 45 grams of protein per day.

Total Fat
Fat should account for less than 30% of your total calories. Consume only unsaturated fats that are low in cholesterol. About 10% to 15% of your total calories should be in the form of monounsaturated fats, such as olive oil, canola oil and peanut oil. Cholesterol intake should be limited to less than 300 milligrams per day.

Consider replacing sugar with artificial sweeteners. Saccharin (Sweet-n-Low), aspartame (Equal), and sucralose (Splenda) are acceptable alternatives.

Sodium intake should not exceed 3,000 mg per day. Those who have high blood pressure, heart disease, kidney disease or liver disease should consume no more than 2,000 mg of sodium per day.

Vitamins and Minerals
Diabetes does not require vitamin or mineral supplements.

Alcohol should be limited to two drinks per day.

Foot Pain due to Diabetes Self Monitoring

An important part of the successful management of diabetic neuropathy is close monitoring of blood sugar.

Blood Testing for Glucose

  • Monitor your blood glucose as directed.
  • Learn to use your glucose monitor correctly.
  • Daily home glucose monitoring is essential.
    • Try to keep your glucose level before meals between 70-110 mg/dl.
    • Two hours after meals, your glucose level should be less than 140 mg/dl.
  • Check your blood sugar before operating a motor vehicle. Raise your blood sugar level by eating, if it falls below 70 mg/dl.
  • Carefully monitor your blood sugars when you are ill. Blood glucose increases when you are ill or have an infection.

When to test your blood glucose:
  • Before meals
  • Before bedtime
  • 1-2 hours after meals
  • 2-3 A.M., at least one night per week

Other reasons to test:

Urine Testing for Ketones
In the past, urine testing was very useful and important. With the advent of rapid blood sugar testing, urine testing is usually not necessary. The main reason to perform this test is to check for early ketoacidosis. Small or trace ketones may mean nothing or represent the beginning of ketoacidosis. If you find this result, then perform the ketone test again in several hours. Notify your physician immediately if you discover moderate to large ketones present in your urine.

Foot Pain due to Diabetes Warning Signs

Continue to Foot Pain due to Diabetes Outlook

Last Updated: Feb 15, 2011 References
Authors: Stephen J. Schueler, MD; John H. Beckett, MD; D. Scott Gettings, MD
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PubMed Foot Pain due to Diabetes References
  1. Corbett CF. Practical management of patients with painful diabetic neuropathy. Diabetes Educ. 2005 Jul-Aug;31(4):523-4, 526-8. [16100329]
  2. Malik RA. Current and future strategies for the management of diabetic neuropathy. Treat Endocrinol. 2003;2(6):389-400. [15981943]
  3. Olson DE, Norris SL. Diabetes in older adults. Overview of AGS guidelines for the treatment of diabetes mellitus in geriatric populations. Geriatrics. 2004 Apr;59(4):18-24. [15086070]
  4. Sullivan KA, Feldman EL. New developments in diabetic neuropathy. Curr Opin Neurol. 2005 Oct;18(5):586-90. [16155445]
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