Diabetic Neuropathy

Diabetic neuropathy is a type of nerve damage that can develop in people with diabetes. Over time, high blood sugar can harm the nerves and the small blood vessels that supply them with oxygen. This can disrupt the messages that travel between the brain and the rest of the body, most commonly affecting the feet and legs.

It is a common complication of diabetes — more than half of people with diabetes develop some form of nerve damage. It often comes on gradually, and some people do not notice it in the early stages, which is why regular diabetes reviews and foot checks matter.

The most common form is peripheral neuropathy, which affects the nerves of the feet, legs, and sometimes the hands and arms. It typically causes numbness, tingling, or pain that starts in the toes and feet and can slowly spread upward.

Another form is autonomic neuropathy, which affects the nerves that control automatic body functions. This can influence digestion, the bladder, sexual function, sweating, and how the heart and blood pressure respond — for example, feeling dizzy when standing up.

Peripheral neuropathy often causes numbness or reduced ability to feel pain and temperature changes, along with tingling, shooting pains, or a burning sensation. These symptoms usually affect the feet and legs first and may be worse at night. Some people also notice muscle weakness or a loss of balance.

When nerves that control internal functions are affected, symptoms can include nausea, constipation or diarrhea, bladder problems, sexual difficulties, and dizziness when changing position. Because numb feet may not feel injuries, cuts, blisters, or sores can go unnoticed.

Diabetic neuropathy is caused by prolonged high blood sugar, which damages nerve fibers and the tiny blood vessels that nourish them. The longer blood sugar stays above target, the greater the risk of nerve damage.

Risk is higher the longer a person has had diabetes and when blood sugar has been poorly controlled. Other factors — such as high blood pressure, raised cholesterol, being overweight, and smoking — can add to the risk by further affecting the blood vessels that supply the nerves.

A doctor usually diagnoses diabetic neuropathy from your symptoms, your diabetes history, and a physical examination. Foot examinations are an important part of this: the doctor checks sensation using a soft filament and tuning fork, tests reflexes, and looks for any skin changes, sores, or areas of pressure.

Blood tests help show how well blood sugar has been controlled over time and can rule out other causes of nerve damage. In some cases, further tests of nerve function are arranged. Regular foot checks are recommended for everyone with diabetes so that any loss of sensation is picked up early.

The foundation of treatment is keeping blood sugar within your target range, as this helps prevent further nerve damage and can slow its progress. Managing blood pressure and cholesterol, eating well, staying active, and stopping smoking all support nerve and blood-vessel health.

For nerve pain, doctors may prescribe specific nerve-pain medicines rather than ordinary painkillers, as these often work better for this type of pain. Your care team can tailor treatment to your symptoms and review it over time to find what helps most.

When the feet are numb, an injury, blister, or pressure sore can develop without being felt and may progress to an ulcer or infection. Looking after your feet greatly lowers this risk.

Helpful daily habits include checking your feet for cuts, redness, or blisters (using a mirror for the soles if needed), washing and drying them carefully, moisturizing dry skin, wearing well-fitting shoes, and never walking barefoot. Attend regular professional foot checks, and report any new sore promptly.

The most effective way to prevent diabetic neuropathy is to keep blood sugar well controlled from early on, alongside managing blood pressure and cholesterol, staying active, and not smoking. These steps also help protect the heart, kidneys, and eyes.

Nerve damage that has already occurred may not fully reverse, but good control can stop it from getting worse, and many people manage their symptoms well. With attentive foot care, most serious foot problems can be prevented. Regular diabetes reviews are key to catching changes early.