Diabetic neuropathy is one of the most common complications of type 1 and type 2 diabetes that over half of all people living with diabetes eventually develop.
The condition is a type of nerve damage that tends to happen slowly over time, so the longer you live with diabetes or uncontrolled blood sugar, the greater your risk.
If you have diabetic neuropathy, you may not notice any symptoms at first. But eventually you might experience numbness, pain, and tingling sensations in your feet, and then elsewhere in your body.
Apart from taking a considerable toll on your health, diabetic neuropathy can also contribute to health and mental health complications, including amputation, depression, and sleep disorders.
Read on to learn more about diabetic neuropathy, including the main signs and symptoms, your options for treatment, and strategies to prevent it.
You’ll likely notice nerve damage in your feet first, says Dr. Sabeena Malik, a board-certified neurologist and assistant professor at the University of Toledo College of Medicine and Life Sciences. Symptoms you may experience include:
Your specific symptoms and their severity can vary. You may experience mild symptoms at first, though they can get worse over time. Eventually, you may begin to notice these symptoms in your hands, as well.
Other symptoms you might experience include:
Note: Symptoms in your upper legs, torso, and other parts of your body usually develop as diabetic neuropathy worsens.
There are four main types of diabetic neuropathy.
This form of neuropathy is the most common. It can affect your feet, legs, arms, and hands.
If you have peripheral neuropathy, you may not notice injuries because you may not experience pain or heat due to the damaged nerves.
But injuries that go untreated can become infected — and if an infection becomes severe enough, it may spread or cause tissue death. In some cases, this may require amputation of the affected limb.
Also called focal neuropathy, this condition occurs when a specific nerve or group of nerves become damaged. It can cause severe pain and weakness in the affected area.
Carpal tunnel syndrome is one common example of mononeuropathy.
Mononeuropathy symptoms may resolve over time without treatment, but if they don’t improve, it’s best to connect with your doctor for more guidance on next steps.
Note: This condition may happen due to diabetes, but it can also happen when you injure or overuse a certain nerve or group of nerves.
Autonomic neuropathy is the second most common type of neuropathy in people with diabetes.
The autonomous nervous system controls the organs that function without your control, like your stomach, intestines, heart, kidneys, and bladder. Damage to the autonomic nerves can make it harder for these organs to function properly, so you may have a harder time noticing and responding to your body’s needs.
For example, neuropathy affecting the bladder could cause incontinence. Neuropathy that develops in your stomach and intestines, on the other hand, could lead to slower digestion, which can ultimately affect your blood sugar.
If the damage affects nerves in your skin and heart, you may not realize when your blood sugar levels drop, due to the absence of tell-tale signs like sweating and a rapid heartbeat.
This form of diabetic neuropathy is also called diabetic amyotrophy. It more commonly affects people who are:
With proximal neuropathy, you’ll usually experience sudden, severe pain with muscle weakness in your hips, thighs, or buttocks. This pain and weakness may extend to your chest, abdomen, and arms.
Typically, it affects only one side of the body at first, but it may involve both sides over time.
After your symptoms begin, they may get worse at first and then slowly begin to improve over six months to a year. Your symptoms may not go away completely, however.
The exact cause of diabetic neuropathy is unknown, but researchers believe it relates to blood sugar levels that remain consistently high over a long period of time.
To put it simply, high blood sugar destroys the blood vessels that provide nutrients to your nerves. Without the nutrients they need, the nerves become damaged and die.
Malik says the main risk factors for diabetic neuropathy are high HbA1C levels and having diabetes for a long time — the longer you live with diabetes, the greater your chances of experiencing nerve damage.
Medical term: The HbA1C test, or Hemoglobin A1C test, measures how well your blood sugar levels were controlled over the past three months. This test can help diagnose diabetes and prediabetes, but it also helps monitor how well your symptoms respond to treatment.
Other contributing factors include:
If you notice numbness and tingling in your feet, along with any other signs of diabetic neuropathy, you’ll want to make an appointment with your doctor right away.
To find the right diagnosis, your doctor may start by asking a few questions about your symptoms, blood sugar management, and any other health concerns you might have.
Typically, they’ll also check your:
They may also recommend nerve function tests, like a nerve conduction velocity test or an electromyography.
While any nerve damage you experience can’t be reversed, treatments for diabetic neuropathy can still ease your symptoms. The main treatment goals include:
Your doctor may prescribe medication and recommend physical therapy to help you achieve these goals.
Medications that may help improve symptoms of diabetic neuropathy include:
Certain physical therapy procedures may also relieve symptoms of diabetic neuropathy like pain and weakness. Examples include:
These medications and other treatments can help ease your symptoms, so it’s essential to follow your doctor’s recommendations and take prescription medications as directed.
Taking extra care of your feet can also make a difference.
These steps can help:
If you live with diabetes, these steps may help lower your chances of developing neuropathy:
Diabetic neuropathy is a common complication of diabetes, but you can reduce your chances of experiencing it by working with your doctor to manage your blood sugar.
Getting regular exercise, following your diet plan, limiting alcohol and stopping smoking can also help prevent this condition.
If you experience symptoms of neuropathy, you can take steps to manage them and keep the condition from getting worse.
Your care team can offer more guidance with exploring your options for treatment and monitoring your symptoms to avoid serious complications, like infection or amputation.
