By Donna Itzstein
Diabetes Qld Pharmacist
Cells need glucose for energy but too much glucose is not good
for our bodies.
High glucose levels may damage the protective coating around our
nerves. This damage can lead to burning, stabbing pain or 'pins and
needles' in the extremities of your body.
This happens generally in the feet and lower legs first and can
also be present in your hands. The name for this condition is
diabetic peripheral neuropathy (DPN).
If these symptoms sound familiar, please talk with your doctor
as there are treatments available.
There is also another possible cause for this condition. If
you're taking Metformin, it.can reduce your Vitamin
B12 levels, and a lack of this vitamin can damage your
myelin sheaths (protective coating of your nerves), so it's
recommended to have your levels checked.
In treating DPN, your doctor may suggest oral medications to
decrease the uncomfortable or painful sensations, which also have
the added benefit of helping you sleep. This is the best option if
you can tolerate them.
The other possibility is to start insulin, if you have not
already, because insulin can heal those nerves to varying degrees.
Exercise will also help reduce the unwanted sensations of DPN.
If these do not work for you or they cause unwanted side
effects, you could try a topical treatment. Unfortunately, most
treatments do not have solid evidence to back up their
effectiveness; however, they may be worth a try.
Treatment with capsaicin 0.075% cream (Zostrix HP) applied to
the painful area four times daily has resulted in significant
relief for some people. Capsaicin is made from a member of the
capsicum (chilli) family.
It works by releasing the substance from nerve endings that
creates pain. Capsaicin pushes the release of this substance and
continually produces a burning sensation at the beginning of
application. As the substance runs out the pain subsides.
Before you run and buy this cream:
- Do not use it if you're allergic to capsicum
- Do not apply Zostrix-HP on broken, cracked or irritated skin.
Do not apply it inside mouth, ear, nose or genitals.
- It must be applied three to four times a day.
- Do not apply a large amount of Zostrix-HP in the affected area;
little and often is the rule to follow. Use a glove to apply the
cream and don't wash the area for 30 minutes.
- Reports state the sensation is worse for up to 28 days before
the pain relief will be felt in six weeks.
Other heat rubs, menthol, methyl salicylate, or arnica creams
with massage may give you temporary relief. Massage may have the
added benefit of also improving circulation. It might be a good
excuse to get that foot rub!
Always be careful standing up after using creams as your feet
may be slippery and you may be at risk of a fall.
The following myths are not helpful for peripheral
- Wrapping your feet in plastic or bandages. This may reduce your
- Placing your feet in cold or very hot water. Cold water
restricts the blood vessels. Very hot water may cause damage to the
skin, including burns, and therefore increases the risk of
Remember to be kind to your feet this winter. Comfortable,
covered shoes or slippers are appropriate.
Diabetes Queensland runs a free-of-charge program to help you
look after your feet called FootSmart. For more information on this
article or FootSmart, contact us on 1800 177 055 or visit the Diabetes Queensland