QUESTION
MY PARTNER is diabetic and has been on dialysis for two months. He follows a good diet, but at night his feet have a burning sensation. It is currently at its worst and he hardly sleeps.
Could you perhaps fully explain the reason and is there a remedy?
His doctor says it’s nerve damage and poor circulation, and his feet are always icy cold. Would a podiatrist help?
He is 56 and still works.

ANSWER
I have loads of empathy for all dialysis patients, as well as their families. Diabetes is a devastating disease. Uncontrolled diabetes
causes alterations to the micro infrastructure of both small and large blood vessels leading to the micro and macrovascular complications of diabetes, causing injury to target organs.
In your partner’s case this seems to be Diabetic Neuropathy – damage caused by ischemia, the shortage of oxygen delivery to the nerve.
Peripheral neuropathy is the most common form of diabetic neuropathy.
The mainstay of treatment is to prevent progression by controlling the blood sugar immaculately, with diet
and good compliance with medication.
Symptomatic control relies on a few tried and tested drugs that work on “nerve pain”, like Amitriptilline, Carbamazepine
and Gabapentin. Alternative treatments would include acupuncture.
Peripheral neuropathy is often referred to as the “glove and stocking” neuropathy. The feet and legs are often
first affected, followed by one’s hands and arms.

Symptoms and signs include:
●Numbness or reduced sensation to pain or temperature
●A tingling or burning feeling
●Sharp, jabbing pain that may be worse at night
●Pain when walking
●Extreme sensitivity to light touch
●Muscle weakness and difficulty walking
●Ulcers.

Diet and good compliance are vital for diabetics

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