Diabetic Neuropathy


Diabetes mellitus (DM) is a condition characterized by high blood sugar levels as a result of reduced insulin production or the body’s resistance to insulin. In Cyprus, approximately 10.3% of the population suffers from this disease.
Peripheral diabetic neuropathy is a common yet chronic complication of diabetes that affects approximately 50% of diabetic patients. It primarily affects the lower limbs; however, it can also affect the upper limbs of the body.


Diabetic neuropathy can go undiagnosed for a long time, especially in the early years of DM. However, once symptoms start to emerge, they typically worsen quickly.
Loss of sensation is one of the most prevalent symptoms, which makes a person prone to skin ulcers, commonly on the bottoms of the feet, before symptoms start to progress upwards. Other symptoms include burning sensation, tingling and numbness in the limbs, while some patients also report experiencing sudden and intense pain.


Causes of Diabetic Neuropathy

The main cause of diabetic neuropathy is long-term exposure of peripheral nerves to high levels of glucose, which causes nerve damage. At the same time, nerve damage is aggravated by blood vessel damage because less nutrients are delivered to the nerve cells. In addition, chronic inflammation that may be caused by various factors also contributes to nerve damage and the development of peripheral diabetic neuropathy.
Despite the fact that diabetic neuropathy can affect every diabetic patient, this risk can be minimized with adequate medical care and proper blood sugar management.

Treatment Options

Conservative drug therapy

  • Antidepressants
  • Anticonvulsants
  • Opioids
  • Lidocaine 5% medicated plaster (Versatis).
  • Capsaicin 8% topical patch (Qutenza) 


Invasive Treatment

In cases where conservative drug therapy is either ineffective or produces severe, intolerable side effects, experimental spinal cord stimulation is indicated. During the trial phase, if the patient experiences more than 50% of relief, the neurostimulation equipment will be permanently implanted.


Regular pain clinic visits and good patient self-care at home are crucial for the efficient management of peripheral diabetic neuropathy. Doctors should monitor the course of treatment as well as patient progress every 4-6 weeks and adjust the regimen as needed.
Applicable and effective treatment of DM itself, along with strict control of blood glucose levels, is vital to both prevent and delay the onset of diabetic neuropathy symptoms.
Fluctuations in glucose can exacerbate the state of the affected nerves, resulting in further damage and pain.
There are many options available for managing pain. For mild pain, comfortable, loose clothing, appropriate shoes with extra support, and over-the-counter pain medications can provide relief.

Alternative Treatments

Acupuncture and vitamin supplements can be helpful for patients looking for alternative options for therapy and pain management. These approaches are used in long-term pain management and may be helpful to patients looking for alternatives to pharmacological therapy.