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Diabetic Peripheral Neuropathy (DPN)
What is it?
DPN is a long-term complication of diabetes where long-term exposure to high blood glucose levels causes damage to the peripheral nerves – the nerves that go to the arms, hands, legs, and feet.
Symptoms
Although DPN can occur in many places in the body, the most common symptoms of DPN are abnormal sensations in the toes and feet, including:
• sharp, shooting pains
• burning
• tingling
• a feeling of being pricked with pins
• throbbing
• numbness (not able to properly feel pain, heat, or cold)
DPN increases the risk for foot ulcers and amputation. Due to the nerve damage in their feet and toes, people with diabetes who have DPN often do not notice minor cuts, sores, or blisters in these areas. If left untreated, these small wounds can easily become infected, lead to gangrene, and may eventually require amputation of the affected area.
What are the risk factors?
• exposure to higher blood glucose levels
• elevated triglycerides
• high body mass index
• smoking
• high blood pressure
Screening for DPN: When should it happen?
For type 1 diabetes:
• Because DPN is uncommon within the first 5 years after onset of type 1 diabetes, annual screening for DPN should begin after 5 years of diabetes diagnosis.
For type 2 diabetes:
• In people with type 2 diabetes, screening for DPN should begin right away, at diagnosis of diabetes, and occur every year after that.
Diagnosing DPN in the feet
Your doctor can test for DPN by lightly pressing a thin nylon rod (10-gram Monofilament) to different areas of your foot (in particular, your big toe) or by using the 128-Hz tuning fork on the back of the big toe to determine if you can feel it. These are easy and pain-free tests.
How can I prevent complications of DPN?
Although there is no cure, there are many ways you can effectively manage DPN:
Proper foot care
- examine your feet and legs daily
- care for your nails regularly
- apply lotion if your feet are dry
- wear properly fitting footwear
- test your bath water before you step in to make sure it’s not too hot
- do not soak your feet
Excellent Blood Glucose Control
- managing your blood glucose levels effectively can help to prevent further nerve damage
Medications
- medications that act on the nerves, including combination therapy with antidepressants, can be helpful
- talk to your doctor about which medications would be best for you
Pain Relievers
- for mild symptoms, acetaminophen can offer some relief
- for severe pain, your doctor may prescribe a narcotic-containing medication
Note: Before taking any medication, it is important to discuss it with your doctor first.
This initiative was made possible through an educational grant by one of Canada’s leading research-based pharmaceutical companies.