Suffering from a chronic condition such as diabetes can be debilitating, and the treatment can be expensive, stressful, and time-consuming. It can become an even bigger issue when a separate chronic condition arises, such as diabetic neuropathy.
Pain management for diabetic neuropathy has become a focus of pain specialists as more and more patients experience this painful and exhausting side effect of diabetes. Effectively treating it can improve your overall quality of life and daily level of function.
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In this guide to managing pain from diabetic neuropathy, we’ll cover:
- What is diabetic neuropathy?
- Symptoms of diabetic neuropathy
- What triggers diabetic neuropathy?
- How high does your blood sugar have to be to cause diabetic neuropathy?
- Why is diabetic neuropathy so painful?
- Why is diabetic neuropathy worse at night?
- The slow progression of diabetic neuropathy
What is Diabetic Neuropathy?
Diabetic neuropathy is nerve damage that develops through type 1 and 2 diabetes. Your nerves are bundles of tissue that carry signals between your brain and other parts of the body to control limb and organ functions.
Diabetic neuropathy often affects the legs and feet, and while some cases are mild, many of them are painful, debilitating, and can even be fatal in certain circumstances. The chance of getting any case of diabetic neuropathy increases the older you are and the longer you have diabetes, meaning that treating it sooner can save you a great deal of pain – or even your life.
Symptoms of Diabetic Neuropathy
Nerve damage from diabetes can affect almost any of the nerves in your body, but diabetic neuropathy is most common in the legs and the feet.
The most common diabetic neuropathy symptoms include:
- Numbness or reduced ability to feel pain
- Inability to register temperature changes
- Burning or tingling sensations near affected nerves
- Increased sensitivity to touch
- Cramps or shooting pains through the legs
- Ulcers, infections, bone pain, or joint pain
- Fluctuating heart rate
These symptoms are often associated with diabetic neuropathy in the legs or feet but can affect any nerves in the body.
What Triggers Diabetic Neuropathy?
Over time, high blood glucose levels (aka blood sugar) and fat levels in the blood from diabetes can damage your nerves. Additionally, there can be damage to the small blood vessels that nourish your nerves with oxygen and nutrients caused by these elevated levels.
How High Does Your Blood Sugar Have to be to Cause Diabetic Neuropathy?
Each person’s target blood sugar level for diabetes maintenance differs, making it tough to assign an exact number. However, this makes it even more important to communicate with your pain clinician or primary doctor about how best to manage these levels.
Additional Causes of Diabetic Neuropathy
Research suggests there’s a potential hereditary link to diabetic neuropathy. However, even within these studies, the most prevalent conditions present in patients with diabetic neuropathy include:
- Smoking
- High blood pressure
- Obesity
- Overdrinking
- Kidney disease
If you are diabetic or pre-diabetic and believe you are suffering from any of these conditions, we recommend talking to your doctor or a pain specialist about prevention steps for diabetic neuropathy.
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Why is Diabetic Neuropathy so Painful?
Diabetic neuropathy is painful due to several metabolic and vascular factors that affect different parts of the body. These include increased sorbitol, fructose, glycol end products, and reactive oxygen species in the blood.
Day-to-day indication of diabetic neuropathy includes excruciating burning and stabbing sensations that are both unpredictable and persistent when they do occur. These are not easily treated by any over-the-counter drug, making prevention and pain management all the more important to discuss with your doctor.
Why is Diabetic Neuropathy Worse at Night?
The symptoms of diabetic neuropathy can flare up for several reasons, including:
- Cooler Temperatures: Neuropathy in your feet is often more prone to cool air. As the temperature drops, your pain and numbness might increase.
- Stress: The end of a long day can bring a buildup of physical stress and mental exertion. This might cause your body to be taxed and your neuropathy to react violently.
- Fewer Distractions: We often push through pain in our daily life because we need to work, care for our family, or attend to daily tasks. As we lie still and try to drift off, the accrued pain and flare-ups of the day may be harder to ignore.
These factors may all increase at night, but your symptoms may vary and worsen at any time. Contact your doctor immediately if you are experiencing persistent pain or numbness in concurrence with diabetes.
Slow Progression of Diabetic Neuropathy
Neuropathies progress slowly in general, and diabetic neuropathy is no exception. Diabetes is often referred to as “The Silent Killer,” and diabetic neuropathy is no exception.
For many, the underlying conditions contributing to diabetes also exacerbate diabetic neuropathy: poor diet, weight fluctuation, and other lifestyle choices that allow for glycemic fluctuation.
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