Skip to content
My WebMD Sign In, Sign Up

Diabetes Health Center

Font Size

Diabetes Nerve Pain May Worsen at Night

People With Diabetic Peripheral Neuropathy Report Worst Pain at 11 p.m., Study Finds
By
WebMD Health News
Reviewed by Laura J. Martin, MD

May 7, 2010 (Baltimore) -- People with diabetes-related nerve damage may experience worse pain in the evening hours, preliminary research suggests.

If confirmed in larger studies, the findings suggest that people with diabetic peripheral neuropathy might need more pain medication late at night.

Peripheral neuropathy is a type of nerve damage associated with type 2 diabetes most often characterized by pain, tingling, and numbness in the hands and feet.

"It could be that patients need more [pain] medication at night or that if they are taking a once-a-day medication, it should be taken in the evening," says Brett Stacey, MD, medical director of the Comprehensive Pain Center at Oregon Health & Science University in Portland.

But it’s too early to make recommendations on the basis of this study, he tells WebMD.

The new findings were presented at the annual meeting of the American Pain Society.

Diabetes Nerve Damage: More Pain at Night

Previous research has shown that people with rheumatoid arthritis often experience worse pain when they wake up than at other times of the day; people with osteoarthritis have worse pain at night.

To begin to investigate whether the pain of diabetic peripheral neuropathy also has a daily pattern, researchers recruited 647 people who reported they'd been diagnosed with the condition.

For seven days, participants kept a diary recording the intensity of their pain every three hours, starting at 8 a.m. They were asked to rate their pain on a 10-point scale, where 10 equals the worst pain imaginable.

The average age of the participants was 54, and 58% were female. Nearly all (92%) were taking prescription or over-the-counter pain medication.

Results showed that average pain scores were highest at 11 p.m. and 8 p.m., when they were 4.65 and 4.53 points, respectively. They dropped to their daily low at 11 a.m., when they averaged 4.21 points.

The association between worse pain and evening hours remained after factors such as age, gender, and other health conditions were taken into account.

Still, the difference between the lowest and highest pain scores was too small to draw any firm conclusions, researchers say.

Diabetes Pain Study: "Hypothesis Generating"

The study has other limitations too, including the fact that participants were recruited via email and that they rated their own pain.

"It's hypothesis-generating," says Michael Clark, PhD, a pain specialist at the Haley VA Medical Center in Tampa, Fla.

Studies like this "tell us whether a hypothesis is worth pursuing," Clark tells WebMD.

"With pain management, we're trying to get away from treating patients based on averages, asking instead when do patients function best and when do they function worst," he says.

The new study was funded by GlaxoSmithKline, for whom Stacey serves as a consultant.

Is This Normal? Get the Facts Fast!

Check Your Blood Sugar Level Now
What type of diabetes do you have?
Your gender:

Get the latest Diabetes newsletter delivered to your inbox!


or
Answer:
Low
0-69
Normal
70-130
High
131+

Your level is currently

If the level is below 70 or you are experiencing symptoms such as shaking, sweating or difficulty thinking, you will need to raise the number immediately. A quick solution is to eat a few pieces of hard candy or 1 tablespoon of sugar or honey. Recheck your numbers again in 15 minutes to see if the number has gone up. If not, repeat the steps above or call your doctor.

People who experience hypoglycemia several times in a week should call their health care provider. It's important to monitor your levels each day so you can make sure your numbers are within the range. If you are pregnant always consult with your health care provider.

Congratulations on taking steps to manage your health.

However, it's important to continue to track your numbers so that you can make lifestyle changes if needed. If you are pregnant always consult with your physician.

Your level is high if this reading was taken before eating. Aim for 70-130 before meals and less than 180 two hours after meals.

Even if your number is high, it's not too late for you to take control of your health and lower your blood sugar.

One of the first steps is to monitor your levels each day. If you are pregnant always consult with your physician.

Did You Know Your Lifestyle Choices
Affect Your Blood Sugar?

Use the Blood Glucose Tracker to monitor
how well you manage your blood sugar over time.

Get Started

This tool is not intended for women who are pregnant.

Start Over

Step:  of 

Today on WebMD

Diabetic tools
Symptoms, diagnosis, treatment, and more.
woman flexing muscles
10 strength training exercises.
 
Blood sugar test
12 practical tips.
Tom Hanks
Stars living with Type 1 or Type 2.
 

Woman serving fast food from window
Video
Can Vinegar Treat Diabetes
Video
 
Middle aged person
Tool
are battery operated toothbrushes really better
Video
 

Prediabetes How to Prevent Type 2 Diabetes
Article
type 2 diabetes
Slideshow
 
food fitness planner
Tool
Are You at Risk for Dupuytrens Contracture
Article