Peripheral diabetic neuropathy or restless legs syndrome in persons with type 2 diabetes mellitus: Differentiating diagnosis in practice

J Am Assoc Nurse Pract. 2015 Dec;27(12):671-5. doi: 10.1002/2327-6924.12311. Epub 2015 Oct 14.


Purpose: Restless legs syndrome (RLS) affects 8% of the population and is identified in 21% of individuals with type 2 diabetes (T2DM). Symptoms of RLS manifest as discomfort in the legs (e.g., numbness, tingling, electrical stimulations), usually occurring at night or at rest (sitting or lying), resulting in the need to move the legs. Peripheral diabetic neuropathy (PDN), which has symptoms similar to RLS, is a common consequence of T2DM. The purpose of this article is to provide nurse practitioners (NPs) with (a) an overview of RLS, (b) the association of RLS with T2DM, (c) the defining characteristics that differentiate PDN from RLS, and (d) implications to improve health outcomes of persons with T2DM.

Data sources: The literature was reviewed for the most current data on RLS and the defining characteristics of PDN.

Conclusions: PDN is a common consequence of T2DM and is described as numbness, tingling, or discomfort in the lower extremities, symptoms that are similar to RLS. Differentiating the symptoms of PDN and RLS may be confusing and result in misdiagnoses, lack of treatment, and poor outcomes.

Implications for practice: It is essential that NPs are knowledgeable about the diagnostic and defining features of RLS as well as the characteristics of other conditions, specifically PDN, which mimics RLS.

Keywords: Neuropathy; adults; diabetes; sleep disorders.

MeSH terms

  • Clinical Competence*
  • Clinical Nursing Research
  • Diabetes Mellitus, Type 2 / nursing
  • Diabetic Neuropathies / diagnosis*
  • Diabetic Neuropathies / nursing*
  • Diagnosis, Differential
  • Humans
  • Nurse Practitioners / organization & administration*
  • Nurse's Role
  • Nursing Assessment / standards
  • Restless Legs Syndrome / diagnosis*
  • Restless Legs Syndrome / nursing*