They are often itchy or painful. Typically the spots turn a brownish color, which fades slowly but is permanent. NLD is not related to any other complication of diabetes. In particular, NLD does not presage eye, kidney or vascular problems. Many of the remainder develop diabetes, and NLD should be considered a warning sign of diabetes.
Reports vary widely on exactly who is most at risk.
Some reports say NLD occurs more often in young women, but some textbooks disagree. The real dangers seem to be ulceration, infection, and the stress from the appearance. Ulceration sometimes occurs spontaneously, and often as a result of trauma. Ulceration is often a result of scratching or trauma, and the ulceration from scratching sometimes heals very slowly. Thus avoiding scratching and trauma decreases the amount of ulceration, though some ulceration will occur anyway.