Most people who have diabetes quickly learn that one of the worst side effects of the disease is pain caused by damage to the hands and feet. High blood sugar inflames nerves, leading to tingling and numbness, and often, severe pain. Researchers at the Comprehensive Pain Center at Oregon Health & Science University in Portland have learned that onset of nerve pain may have a daily rhythm, with the worst occurring late at night around 11 p.m. Their study, which they characterized as “preliminary,” tracked 647 people with diabetic neuropathy. The results showed that the typical pattern for people with the condition was to experience the greatest pain from it after sunset, peaking at 8 p.m. and 11 p.m.
Study participants averaged 54 years in age and were divided between 42 percent men and 58 percent women. Ninety-two percent were taking either prescription or over-the-counter pain medications. The participants tracked the intensity of their pain at three-hour intervals over a seven-day span, starting at 8 a.m. and ending at 11 p.m., rating their pain on a 10-point scale, with 10 representing the worst imaginable pain. Their lowest pain level of the day was an average of 4.21 points at 11 a.m. By 8 p.m., that average rose to 4.53 points, and by 11 p.m. to 4.65 points, the highest of the recorded day.
Although the study suggests levels of neuropathic pain differ throughout the day, the statistical difference between the high and low measures of it are not enough for scientists to offer any strong conclusions. One tentative conclusion is that people who are taking pain medications may want to take an extra dose at night, or if they are on once-a-day medications, delay taking them until then. The study also suggests that diabetes patients may be more effectively treated for symptoms and side effects if their subjective experiences of pain are taken into account.
Researchers began looking into neuropathic pain patterns after seeing that previous research had shown that other painful conditions have predictable times when they are most intense. For example, osteoarthritis patients experience their worst pain at night while rheumatoid arthritis sufferers are more likely to feel the most intense pain of the day soon after waking up in the morning.
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