By Rob Wotton
Sunshine Coast Podiatrist
What is diabetic peripheral neuropathy?
Diabetic peripheral neuropathy refers to damage of the nerves of
the hands and/or feet caused by diabetes. It usually affects the
How does it occur?
Extended periods of high blood glucose can damage nerves,
causing either reduced sensation (numbness) or cause them to become
highly sensitive resulting in pain or intense discomfort. The
effects of diabetic peripheral
neuropathy can be worsened by sudden changes to blood glucose
There are other types and causes of peripheral neuropathy, but
in this article we will concentrate on diabetic peripheral sensory
How is it diagnosed?
A diagnosis of diabetic peripheral neuropathy is made from a
detailed history of your symptoms and a physical examination, which
will include testing your feeling with simple instruments such as a
thin piece of monofilament and/or a tuning fork. There are other
nerve conduction tests that can be performed by a neurologist when
the diagnosis is unclear.
There are two types of diabetic peripheral sensory neuropathy:
painlessand painful. It can be common to experience both painless
and painful types.
Painless diabetic peripheral neuropathy
Painless peripheral neuropathy is often described as numbness or
a loss of sensation in the feet. Due to the numbness, you cannot
feel when your feet are injured.
You may also experience a loss of balance and coordination as
you are less aware of where your legs, hands and feet are in
relation to the rest of your body. This increases the risk of trips
Painful diabetic peripheral neuropathy
Painful peripheral neuropathy is often described as
pins-and-needles, tingling, burning and/or sharp shooting pain.
This pain can be worse at night time, interfering with sleep and
You may feel like you are walking on cotton wool, a pillow, hot
coals or rocks. The pain can last for a short time or be chronic in
nature, requiring ongoing therapy and support.
If you are experiencing painful diabetic peripheral neuropathy
benefit from a clear explanation, ongoing support and a
What is the treatment?
The aim of treatment is to reduce your pain and improve quality
of life. The simplest initial treatment is improving your blood
glucose levels to prevent any further nerve deterioration. It is
very important that you monitor your levels to maintain
There are also medications and treatments out there to help
manage the pain of diabetic peripheral neuropathy and these should
be discussed with your healthcare team.
What can I do to help?
Manage your blood glucose levels.
Maintain a healthy lifestyle and engage in regular physical
How do I look after my feet?
For people with diabetes, regular foot inspection and care are
vital to prevent complications:
- Conduct daily foot inspections -If you are unable to do this,
then a partner or family member can help. Alternatively, a mirror
placed at the end of a bed can help with better inspection;
- Keep your feet clean and dry- Moisturise daily to avoid dry
skin and/or callus. Avoid moisturizer between your toes, as this
skin needs to stay dry to avoid infection;
- Professional foot care- See a podiatrist on a regular basis.
They are health professionals trained in the diagnosis, assessment
and treatment of a range of diabetic foot problems;
- Footwear- wear properly fitting footwear that is stable,
protective and cushioned. It is important to check your shoe size
regularly because minor blisters caused by rubbing can quickly
What do I do if I have a problem?
If you have any problems you should discuss them with your
healthcare team. Just because it may not hurt, doesn't mean it
can't be damaging. This is particularly important if you experience
a loss of sensation as a result of painless peripheral neuropathy.
If you notice a sore, don't ignore it.
There are a range of dedicated healthcare professionals such as
your doctor, podiatrist, diabetes educator, clinical nurse and
pharmacist who can help you with advice about the day-to-day
management of your diabetes and diabetic neuropathy.
The important thing to remember is that you are not alone.