Diabetic Peripheral Neuropathy
Diabetes mellitus is a disease that causes high levels of glucose (sugar) in the blood. Based on statistics from 2005, 20.8 million people in the U.S. have diabetes.Diabetes can be a cause of pain. Diabetic peripheral neuropathy (DPN) is a condition that can often result in debilitating chronic pain for diabetics.
What Is Diabetic Peripheral Neuropathy?
DPN is a type of nerve damage that is caused by diabetes. It affects mainly the hands and feet, in what is called a "stocking and glove" pattern.DPN usually develops gradually. Over time it can cause severe pain and loss of function.
What Are the Symptoms?
- Pain in the hands and/or feet
- Burning sensations
- Numbness
- Tingling sensations
- Weakness in the feet and hands
- Decreased balance
- Foot deformities
- Dry skin on the hands and feet
How Is it Diagnosed?
A diagnosis of DPN is partly based on your symptoms and findings from a physical examination.Electrodiagnostic testing may be ordered or performed by your doctor. Nerve conduction studies can determine if your nerves are functioning properly.
What Are the Complications?
People with DPN can develop open wounds on the skin (most commonly on the feet) that can become infected. If the infection is severe or the wound does not heal, part of the limb may have to be amputated.Is There Treatment?
The first step in treating diabetic neuropathy is to get the blood sugar under control. It is crucial that prescribed medications for diabetes are taken regularly. Diet and exercise are a very important part of treatment. Foot care is essential. Since the feet may be numb, you may not notice small cuts and open areas. The feet must be kept clean and inspected at least twice a day. A podiatrist can be an important part of your healthcare team.Some medications can be useful:
- Analgesics Standard pain medications such as acetaminophen can be helpful for mild cases of DPM.
- Antidepressants Low doses of certain antidepressants may be prescribed by your doctor. Pregabalin and duloxetine are commonly used antidepressants that have been shown to decrease the pain from DPN.
- Anticonvulsants Low doses of anticonvulsants may help to relieve the pain. Gabapentin is a commonly used anticonvulsant for the treatment of DPN.
Sources:
Publication No. 06–3892 November 2005 National Center for Health Statistics, Centers for Disease Control and Prevention. 1999–2002 National Health and Nutrition Examination Survey (NHANES). Available at www.cdc.gov/nchs/nhanes.htm. National Center for Health Statistics, Centers for Disease Control and Prevention. 1999–2003 National Health Interview Survey (NHIS). Available at www.cdc.gov/nchs/nhis.htm. U.S. Census Bureau, resident population estimates for 03/01/05. Available at www.census.gov/popest/national/asrh/2004_nat_res.html. Cowie CC, Rust KF, Byrd-Holt D, et al. "Prevalence of diabetes and impaired fasting glucose in adults—United States, 1999–2000. "MMWR. 2003;52(35):833–837.