About Diabetes

Peripheral Neuropathy

The most common type of neuropathy is peripheral neuropathy. It affects the nerves in the hands, feet, legs, and arms. It generally starts in the feet, and it tends to start in both feet at once.

ABOUT DIABETES

Don’t Let Diabetes Get on Your Nerves

The nerves in your feet provide a natural alarm system. Diabetes can shut it off and result in undetected foot problems. Learn the ABCs of peripheral neuropathy.

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Symptoms

Look at the list below, make a note about any symptoms you have and share it with your doctor during your next office visit. Often the symptoms, especially those of burning or shooting pain, are worse at night. Eventually the painful symptoms stop but the person now has a chronic feeling of numbness or coldness in their feet.

  • My feet tingle.
  • I feel "pins and needles" in my feet.
  • I have burning, stabbing or shooting pains in my feet.
  • My feet are very sensitive to touch. For example, sometimes it hurts to have the bed covers touch my feet.
  • Sometimes I feel like I have socks or gloves on when I don't.
  • My feet hurt at night.
  • My feet and hands get very cold or very hot.
  • My feet are numb and feel dead.
  • I don't feel pain in my feet, even when I have blisters or injuries.
  • I can't feel my feet when I'm walking.
  • The muscles in my feet and legs are weak.
  • I'm unsteady when I stand or walk.
  • I have trouble feeling heat or cold in my feet or hands.
  • It seems like the muscles and bones in my feet have changed shape.
  • I have open sores (also called ulcers) on my feet and legs. These sores heal very slowly.

Diagnosis

Foot exams

Have a complete foot exam once a year. If you already have foot problems, have your feet checked more often. A complete foot exam includes a check of the skin on your feet, your foot muscles and bones, and your blood flow. Your provider will also check for numbness in your feet by touching your foot with a monofilament. It looks like a stiff piece of nylon fishing line or a bristle in a hairbrush.

Other ways to check your nerves include using a tuning fork. It may be touched to your foot to see if you can feel it moving.

Nerve conduction studies and electromyography (EMG)

If the doctor thinks you might have nerve damage, you may have tests that look at how well the nerves in your arms and legs are working. Nerve conduction studies check the speed with which nerves send messages. An EMG checks how your nerves and muscles work together.

Treatment

While keeping blood glucose levels in goal range can prevent peripheral neuropathy and keep it from getting worse, there aren’t any treatments that can reverse nerve disease once it’s established. Once neuropathy is detected, the focus is on keeping the feet and legs healthy and on managing pain. To treat nerve damage, you will need to keep your blood glucose levels in your target range, manage your pain and protect your feet. Many people get depressed when they have nerve damage and may need medication for depression as well as counseling.

Medications

Medications to relieve pain and reduce burning, numbness and tingling are available. Some of these are known for their use in other conditions but they still seem to help those with nerve damage.

Speak with your doctor to find out what treatments are best for you.