Diabetic Polyneuropathy

What is diabetic polyneuropathy?

Diabetic polyneuropathy is a neurological disorder (neuropathy) of all the nerves in the body (polyneuropathy) as a result of diabetes. It can be accompanied by pain and/or loss of function when these nerves do not work properly.


Diabetic polyneuropathy can be the result of the direct toxic effect of sugar (glucose) on the cell bodies of the nerves. The damage to the nerves is also accompanied by a disorder of the blood vessels that supply the nerves with blood. Diabetes patients who have or may acquire deregulated sugar levels are therefore more likely to suffer from diabetic polyneuropathy and/or pain. Other factors also play a role, such as high blood pressure and, even more importantly, high cholesterol levels in the blood. About half the diabetes patients with polyneuropathy have symptoms of pain.

Signs and symptoms

More than 80% of diabetes patients with polyneuropathy have symptoms in their hands and feet. The symptoms usually start in the feet and gradually move higher up the legs. Once the symptoms reach the knees then there are usually also symptoms in the hands. The symptoms of neuropathy are sometimes the first signs of diabetes. The first symptoms are signs of reduced sensation and burning feelings in the feet, occurring mostly at night and becoming worse when touched, and tingling feelings in the feet. Waves of shooting pain can also occur. Even if the pain symptoms are not too bad, there may already be changes in sensation. Severe polyneuropathy can lead to gait problems since sensation in the feet is affected. The feet are sometimes painful to the touch.

How is diabetic polyneuropathy diagnosed?

A general physical examination and an extensive neurological examination are highly important. The following tests should be included in the neurological examination: (1) sensory tests of the arms and legs, (2) reflexes and (3) strength tests.

Do I need additional examinations?

  • Diagnostic examination for other non-physical factors important for your pain, have already been done by yourself trough filling out your pain questionnaires.
  • EMG.
  • Examination by a physician for Internal Medicine.

What are my treatment possibilities?

Multidisciplinary Treatment

Depending on the cause of your pain, your pain specialist will decide whether or not to embark on physical treatment. Based on the results of the completed pain questionnaire, additional examinations can be carried out and, apart from physical treatment, other methods of treatment will be suggested.

Non-physical Treatments

If the results of your pain questionnaire are abnormal, your pain specialist will offer you one of the non-physical treatments listed below:

Physical Treatments


Other Treatments

Interventional Pain Treatments

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