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What Is Diabetic Neuropathy?
Diabetic neuropathy is nerve damage caused or contributed to by diabetes. It most often affects the nerves in the feet and legs, but it can also affect the hands, digestive system, urinary system, heart, blood vessels, or other nerves. The condition may develop when diabetes-related changes injure nerves and the small blood vessels that support them. Recognizing diabetes and neuropathy early can help reduce the risk of serious problems.
Symptoms
Symptoms of Diabetic Neuropathy
- Burning pain
- Tingling
- Numbness
- Increased sensitivity to touch
- Reduced ability to feel heat or injury
- Muscle weakness
- Balance problems
- Foot sores that may go unnoticed
Symptoms Beyond the Feet
Symptoms depend on which nerves are affected and may develop gradually. Other patterns can cause dizziness when standing, digestive changes, bladder problems, sexual problems, sweating changes, or sudden localized weakness. Some people have nerve damage without noticeable symptoms, which is one reason routine screening matters.
Act promptly
Do not ignore foot injuries
Reduced sensation can make a serious problem difficult to notice. Seek prompt medical advice for:
- A new foot wound or sore
- Spreading redness
- Severe swelling
- Sudden weakness
- Rapidly worsening symptoms
Causes
What Causes Diabetic Neuropathy?
Chronically high blood glucose can damage nerve fibers and the small blood vessels that supply them. High blood pressure, abnormal cholesterol, inflammation, and smoking may add to nerve injury. Diabetic neuropathy can occur in people with type 1 or type 2 diabetes, and more than one factor may contribute. These changes explain some of the causes of neuropathy in the feet and other parts of the body.
- High blood glucose over time
- Reduced blood flow to nerves
- Oxidative or inflammatory stress
- Pressure or injury to an already vulnerable nerve
Risk Factors
Risk Factors for Diabetic Neuropathy
Factors you can address
These include blood glucose management, blood pressure, cholesterol, smoking, alcohol use, excess weight, physical activity, kidney health, nutrition, and regular foot care. Addressing these factors may lower the risk or severity of diabetic peripheral neuropathy.
Factors you cannot fully change
Risk also increases with age, a longer duration of diabetes, kidney disease, existing nerve disease, and other diabetes complications. These factors cannot always be changed, but monitoring and early care can still reduce complications.
Having a risk factor does not guarantee that you will develop neuropathy, and people without obvious risk factors can still develop symptoms. Your clinician can review your individual risks and help create a plan for diabetes and neuropathy care.
Complications
Complications of Diabetic Neuropathy
- Unnoticed cuts or burns
- Infected foot wounds
- Foot ulcers
- Charcot foot changes
- Falls
- Amputation risk
- Digestive problems
- Bladder problems
- Sexual dysfunction
- Blood pressure or heart-rate changes
Numbness can hide an injury until it becomes infected or difficult to heal. Daily foot checks, well-fitting footwear, and prompt treatment of wounds can reduce the chance of serious complications, including problems linked with neuropathy in the feet.
Diagnosis
How Diabetic Neuropathy Is Diagnosed
Diagnosis is based on your symptoms, diabetes history, a neurological examination, and a detailed foot examination rather than one single test. A clinician considers which nerves may be affected and looks for other possible explanations for your symptoms.
- Monofilament or light-touch testing
- Vibration testing
- Reflex checks
- Muscle-strength assessment
- Skin and footwear inspection
- Review of blood glucose and other health conditions
Blood tests, nerve conduction studies, electromyography, or specialist evaluation may be used when symptoms are unusual, rapidly progressive, asymmetric, or possibly caused by another condition. These tests can help investigate idiopathic neuropathy, idiopathic peripheral neuropathy, vitamin problems, medication effects, or other disorders.
Treatment & Management
Diabetic Neuropathy Treatment and Management
Manage Diabetes and Related Risks
Work with your healthcare team to improve glucose, blood pressure, cholesterol, kidney health, nutrition, physical activity, and smoking status as appropriate. Ongoing diabetes management may slow progression or prevent additional nerve damage, but established nerve injury may not fully reverse. Targets should be individualized with a clinician.
Relieve Symptoms and Prevent Injury
Clinician-prescribed medicines may help manage painful neuropathy. Inspect numb feet safely each day, wear protective footwear, and obtain prompt treatment for wounds. Physical therapy or balance support may help with weakness or falls, while digestive, urinary, sexual, or other autonomic symptoms may need specific treatment. Do not start over-the-counter pain medicines or supplements without medical guidance.
Prevention & Screening
Preventing Diabetic Neuropathy and Screening for Nerve Damage
Keeping blood glucose, blood pressure, and cholesterol in an individualized target range may lower risk or slow progression. Not smoking, staying active safely, and limiting alcohol can also help, although prevention is not always complete. Your diabetes care plan should include regular foot and nerve checks.
| Check | Who does it | What it includes | Purpose |
|---|---|---|---|
| Daily foot check | Person with diabetes | Skin color, cracks, blisters, swelling, wounds, and changes in temperature | Find injuries early when sensation may be reduced |
| Routine clinical foot and nerve assessment | Diabetes clinician or foot specialist | Sensation, pulses, reflexes, skin, footwear, and foot structure | Detect neuropathy and estimate complication risk |
| Additional evaluation | Clinician or specialist | Targeted tests when symptoms or examination findings are unusual | Look for another cause or a more serious nerve problem |
Ask your care team how often you need a comprehensive foot and nerve assessment. Do not wait for the next scheduled visit if a new wound, change in color or temperature, or new symptom appears.
Outlook and Prognosis
Outlook and Prognosis for Diabetic Neuropathy
Diabetic neuropathy is usually a long-term condition rather than a short illness. The outlook depends on how long you have had diabetes, glucose and cardiovascular risk control, the nerves affected, and whether complications have developed. Early recognition and ongoing care may slow progression and reduce serious problems.
When Should You See a Doctor
When Should You See a Doctor?
Arrange a medical visit for new or worsening numbness, tingling, burning pain, weakness, balance problems, digestive or bladder changes, or symptoms that interfere with sleep or daily activities. Evaluation of diabetic neuropathy symptoms can help identify treatable causes and prevent complications such as diabetic foot pain or wounds.
Seek medical help
Prompt care needed
Contact a clinician promptly for a foot problem, and seek urgent or emergency care when symptoms are severe or sudden. Red flags include:
- Foot wound, blister, or burn
- Discoloration, warmth, swelling, or drainage
- Fever or rapidly spreading redness
- Sudden severe weakness
- Sudden loss of function



