KNOW YOUR PAIN
PAINFUL DIABETIC POLYNEUROPATHY
WHAT IS PAINFUL DIABETIC POLYNEUROPATHY?
Neuropathy is a complication of diabetes, a disease in which people have high levels of blood sugar over a prolonged time period, and it can lead to problems throughout the body.1 Neuropathy is damage or dysfunction of one or more nerves and polyneuropathy is the damage or dysfunction of multiple nerves that extend from the spinal cord to the arms, hands, legs and/or feet.
It is estimated that diabetic polyneuropathy (DPN) affects nearly 50% of adults with diabetes during their lifetime.2
People with diabetes can often have localised nerve damage that may cause a type of chronic pain known as painful DPN (also referred to as diabetic nerve pain or diabetic peripheral neuropathy), which is a type of neuropathic pain.
WHAT CAUSES PAINFUL DIABETIC POLYNEUROPATHY?
There are a number of factors that may contribute or increase the risk of a person with diabetes developing DPN, these include:
- High blood sugar (glucose), which can cause chemical changes in nerves and impairs their ability to transmit signals1
- Metabolic factors, such as high triglyceride and cholesterol levels (which are frequently monitored in patients with diabetes), as well as being overweight or obese1
- Length of time a person has had diabetes3,4
These factors also increase the risk of a person with diabetes developing painful DPN,3 which is why control of diabetes is so important.
WHAT ARE THE TYPICAL SYMPTOMS OF PAINFUL DIABETIC POLYNEUROPATHY?
Although painful DPN can affect all body parts, it is most commonly localised to the extremities, starting in the feet (e.g. the toes and soles of the feet).5 Over time the neuropathy moves to the hand and has a pattern like ‘socks and gloves’. This is why painful DPN is also referred to as a type of localised neuropathic pain.6
The chronic pain associated with DPN can be described as ‘burning’, 'piercing’, ‘stabbing’ or ‘freezing’ pain. Other symptoms associated with DPN include numbness, tingling and weakness and unsteadiness.5
HOW IS PAINFUL DIABETIC POLYNEUROPATHY DIAGNOSED?
A physical examination and a neurological examination are very important to help diagnose painful DPN. Part of the neurological examination is a test of your reflexes, testing sensation in your arms and legs, and a strength test.
The healthcare professional might also ask about pain intensity (using a pain scale), duration, frequency and other observations in your daily life. It is important to describe your symptoms in as much detail as possible.1,7,8
WHAT CAN YOU DO?
Medication can help, including glucose control, and early treatment may help to reduce the symptoms of painful DPN,1 so it is important to see a healthcare professional for advice regarding diabetes and painful DPN.
If you have diabetes and think that you might have painful DPN, please fill out the My Pain Questionnaire and see a doctor at your earliest convenience. Be sure to tell your doctor that you have diabetes and now have chronic pain.
In addition, the Pain Diary can be used to help document and keep track of a person’s pain condition; how they feel each day, whether they are coping, their current level of pain and any side effects of the treatment(s) prescribed/recommended.
Other kinds of pain
1. Callaghan BC et al. Lancet Neurol 2012;11:521–34.
2. Hicks CW & Selvin E. Curr Diab Rep 2019;19:86.
3. Sundara Rajan R et al. Contin Educ Anaesth Crit Care Pain 2014;14:230–5.
4. Tesfaye S et al.N Engl J Med 2005;352:341–50.
5. Feldman EL et al. Nat Rev Dis Prim 2019;5: 1–18.
6. Mick G et al. Pain Manag 2012;2:71–7.
7. Morlion B et al. Curr Med Res Opin 2018;34:1169–78.
8. Kress HG, Aldington D, Alon E, et al. Curr Med Res Opin 2015;31:1743–54.