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Diabetic Neuropathy

  • Krisha McCoy, MS
Publication Type:


Diabetic Neuropathy

(Nerve Damage of Diabetes)


Diabetic neuropathy is a type of nerve damage linked to diabetes. It can damage any nerve in the body. The types of neuropathy include:

  • Peripheral neuropathy (most common)—causes pain or loss of feeling in the toes, feet, legs, hands, and arms
  • Autonomic neuropathy—causes changes in nerves controlling body function, including:
    • Digestion, bowel and bladder function
    • Sexual response
    • Sweating
    • Heart and blood pressure control
    • Breathing
    • Vision
  • Proximal neuropathy—causes pain in the thighs, hips, or buttocks and weakness in the legs
  • Focal neuropathy—only affects one nerve or a group of nerves
Nerves of the Foot.

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Diabetic neuropathy is likely caused by a mix of things, such as:

  • Metabolic factors like:
    • Elevated blood pressure
    • High blood glucose
    • Longer duration of diabetes
    • High cholesterol
    • Possibly low levels of insulin
  • Damage to blood vessels going to nerves
  • Autoimmune factors causing inflammation of nerves
  • Nerve trauma
  • Genetics
  • Smoking or alcohol abuse

Risk Factors

Diabetic neuropathy is more common in older adults.

Things that may raise the risk include:


Symptoms of diabetic neuropathy may include:

  • Numbness, tingling, or pain in the extremities
  • Digestive problems, such as:
  • Lightheadedness
  • Urination (peeing) problems
  • Erectile dysfunction or vaginal dryness
  • Problems with muscles, such as:
    • Weakness of face muscles
    • Problems swallowing
    • Weakness in the arms and/or legs
    • Muscle cramps
  • Less sweating
  • Blurred or double vision

Other neuropathies may also happen, such as carpal tunnel syndrome.

Diabetic neuropathy can lead to serious problems, such as:


The doctor will ask about symptoms and past health. A physical exam will be done. A foot exam will also be done.

Tests will be done to make the diagnosis and rule out other causes. Tests will depend on the specific problems. They may include:

  • Blood tests—to look for abnormalities
  • Nerve function tests, such as:
  • Imaging of body structures with:
    • Magnetic resonance neurography (MRN)
    • Ultrasound
    • Barium study of stomach—to check for a blockage
  • Electrocardiography (ECG)—to check for heart effects
  • Biopsy—to test the nerves


Treatment may include:


To help prevent diabetic neuropathy, regularly check and manage:

  • Blood glucose levels
  • Blood pressure
  • Cholesterol levels

The doctor can tell you how often to do this and what the numbers mean.

Blood Glucose Management

It is important to regularly monitor blood glucose levels. Meal planning, exercise, and/or medicines can help.





  • Diabetic neuropathies: the nerve damage of diabetes. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-problems/nerve-damage-diabetic-neuropathies.
  • Diabetic peripheral neuropathy. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/diabetic-peripheral-neuropathy.
  • Macaré van Maurik JF, Oomen RT, et al. The effect of lower extremity nerve decompression on health-related quality of life and perception of pain in patients with painful diabetic polyneuropathy: a prospective randomized trial. Diabet Med. 2015;32(6):803-809.
  • Price R, Smith D, et al. Oral and topical treatment of painful diabetic polyneuropathy: Practice guideline update summary: Report of the AAN Guideline Subcommittee. Neurology. 2022 ;98(1):31-43.


  • April Scott, NP
Last Updated:

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.