Question:

Question: I have diabetic neuropathy (P.N.) in my feet. It has been progressing the last couple of years. I’m now taking 1600 mlg daily of gabapentin. I guess my question is what are my feet supposed to feel like? Right now I feel like I’m walking barefoot on semi hard sponge. I have drop foot in both but the left is worse. I’m looking for someone who could share some thoughts.

Thank you so much for your time.


Answer:

In general, with diabetic neuropathy, sensation and motor function in the feet can be impaired to varying degrees. The typical impairments seen range from loss of light touch sensation to loss of pinprick sensation to complete loss of sensation in the foot in extreme cases. Foot-drop due to weakness of muscles that control the foot is another common impairment seen with people with neuropathy. Foot-drop results in being unable to lift the foot against gravity and is often first noticed when tripping or falling due to catching the toes on the ground while walking.

With diabetic neuropathy, symptoms can be progressive in nature and worsen over time. The best way to prevent diabetic neuropathy from getting worse is by controlling glucose levels. Checking glucose daily along with monitoring what you are eating is a great way to start understanding your glucose levels. Diabetes.org is a great website that offers a lot of information regarding what diabetes is and how to manage glucose appropriately. Additionally, you should be following up with endocrinology for diabetes management if you are not already. Podiatry could also be of benefit to evaluate your feet and may offer supportive bracing. A registered dietician can also be a great resource to address the nutritional aspect of diabetes management. If you are not seeing these providers, you could ask your primary care provider if they can be a part of your medical team.

I believe that having an evaluation by a physical therapist can be very helpful for you also. A physical therapist will be able to assess foot sensation and strength. They may also be able to suggest appropriate muscle strength exercises and general exercises that would play a significant role in managing glucose levels and preventing worsening neuropathy. Balance can often be an issue with neuropathy as well; a physical therapist would further be able to evaluate your balance and suggest ways to improve it.

I hope you find this response helpful and please reach out with any other questions.


**This reply is for informational purposes only. It’s not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician, physical therapist, or other qualified health provider with a medical condition.