What lifestyle modifications should I advise to patients with diabetic neuropathy to help manage their symptoms?

Advise patients with diabetic neuropathy to adopt lifestyle modifications that focus on optimal blood glucose control, foot care, and symptom management to help alleviate their symptoms and prevent complications. Maintaining good glycaemic control is essential to slow neuropathy progression and reduce symptom severity. Patients should be educated on the importance of regular blood glucose monitoring and adherence to diabetes management plans. Foot care advice is critical, including daily inspection of feet for injuries or ulcers, proper hygiene, and wearing appropriate footwear to prevent pressure sores and infections. Patients should be informed about the risks of foot ulcers and the need to seek prompt medical attention for any foot problems. Dietary modifications such as avoiding high-protein diets in those with diabetic nephropathy and following a small-particle-size diet (e.g., mashed or pureed foods) may be advised in cases of gastroparesis associated with autonomic neuropathy. Physical activity tailored to the patient's abilities can improve circulation and overall health but should be balanced with foot protection strategies to avoid injury. For symptom relief, patients may benefit from education about the self-limiting nature of acute painful neuropathy following rapid glucose improvement and the potential need for regular pharmacological treatment to manage pain. Referral to multidisciplinary foot care services is recommended for active foot problems or ulcers to ensure comprehensive management including offloading and wound care. Information provision should be both oral and written, covering the nature of neuropathy, foot care, emergency contacts, and the importance of glycaemic control to empower self-management.

These lifestyle modifications integrate UK guideline recommendations emphasizing education, foot care, and glycaemic control ¹ with recent literature highlighting the importance of symptom management and multidisciplinary approaches (Mallick-Searle and Adler, 2024).