Diabetic neuropathy; Diabetes - neuropathy; Diabetes - peripheral neuropathy
Nerve damage that occurs in people with diabetes is called diabetic neuropathy. This condition is a complication of diabetes.
In people with diabetes, the body's nerves can be damaged by decreased blood flow and a high blood sugar (glucose) level. This condition is more likely when the blood sugar level is not well controlled over time.
About one half of people with diabetes develop nerve damage. Symptoms often do not begin until many years after diabetes has been diagnosed. Some people who have diabetes that develops slowly already have nerve damage when they are first diagnosed.
People with diabetes are also at higher risk for other nerve problems not caused by their diabetes. These other nerve problems won't have the same symptoms and will progress in a different manner than nerve damage caused by diabetes.
Symptoms often develop slowly over many years. The types of symptoms you have depend on the nerves that are affected.
Nerves in the feet and legs are most often affected. Symptoms often start in the toes and feet, and include tingling or burning, or deep pain. Over time, nerve damage can also occur in the fingers and hands. As the damage gets worse, you may lose feeling in your toes, feet, and legs. Your skin may become numb. Because of this, you may:
When the nerves that control digestion are affected, you may have trouble digesting food due to reduced movement of the stomach (gastroparesis). This can make your diabetes harder to control. Damage to nerves that control digestion almost always occurs in people with severe nerve damage in their feet and legs. Symptoms of digestion problems include:
When nerves in your heart and blood vessels are damaged, you may:
Other symptoms of nerve damage are:
The health care provider will do a physical exam. The exam may find that you have the following:
Tests that may be ordered include:
Your provider should check to see if your blood vitamin B12 level is normal, as low levels can contribute to neuropathy symptoms.
Follow your provider's advice on how to slow diabetic nerve damage.
Control your blood sugar (glucose) level by:
To treat the symptoms of nerve damage, your provider may prescribe medicines to treat:
If you're prescribed medicines for symptoms of nerve damage, be aware of the following:
When you have nerve damage in your feet, the feeling in your feet can be reduced. You can even have no feeling at all. As a result, your feet may not heal well if they are injured. Caring for your feet can prevent minor problems from becoming so serious that you end up in the hospital.
Caring for your feet includes:
Many resources can help you understand more about diabetes. You can also learn ways to manage your diabetic nerve disease
Treatment relieves pain and controls some symptoms.
Other problems that may develop include:
Contact your provider if you develop any symptoms of diabetic neuropathy.
Brownlee M, Aiello LP, Sun JK, et al. Complications of diabetes mellitus. In: Melmed S, Auchus RJ, Goldfine AB, Koenig RJ, Rosen CJ, eds. Williams Textbook of Endocrinology. 14th ed. Philadelphia, PA: Elsevier; 2020:chap 37.
ElSayed NA, Aleppo G, Aroda VR, et al. 12. Retinopathy, neuropathy, and foot care: standards of care in diabetes-2023. Diabetes Care. 2023;46(Suppl 1):S203-S215. PMID: 36507636 pubmed.ncbi.nlm.nih.gov/36507636/.BACK TO TOP
Review Date: 2/10/2023
Reviewed By: Sandeep K. Dhaliwal, MD, board-certified in Diabetes, Endocrinology, and Metabolism, Springfield, VA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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