Diabetic Neuropathy

Last Updated September 2023 | This article was created by familydoctor.org editorial staff and reviewed by Peter Rippey, MD, CAQSM

What is diabetic neuropathy?

Diabetic neuropathy is a type of nerve damage that happens in people who have diabetes. This damage makes it hard for their nerves to carry messages to the brain and other parts of the body.

Symptoms of diabetic neuropathy

Diabetic neuropathy can cause the following symptoms:

  • Changes of sensation, numbness (loss of feeling), or painful tingling and burning in parts of the body, especially your feet, legs, and toes
  • Muscle weakness and difficulty walking
  • Your feet heal slowly when you get cuts, sores, or blisters on them. Also, they don’t hurt as much as you would expect

What causes diabetic neuropathy?

Diabetes causes the level of sugar in your blood to be higher than normal. Over time, high blood sugar levels damage your blood vessels and nerves. That’s why people whose blood sugars are not well controlled are more likely to get diabetic neuropathy.

Men are more likely to have diabetic neuropathy than women. High cholesterol levels and smoking also increase your risk.

How is diabetic neuropathy diagnosed?

Your doctor or nurse should check your feet periodically when you go in for a visit. If you are diabetic and have symptoms of diabetic neuropathy, your doctor will take a complete health history and perform a physical exam. If you have never been diagnosed with diabetes, your doctor may order a blood test first. Nerve function tests may be used to diagnose diabetic neuropathy. Nerve function tests will measure your response to electrical signals, sensitivity to touch, and changes in temperature.

Can diabetic neuropathy be prevented or avoided?

The most important thing is to keep your blood sugar under control. Take your medicines and/or insulin exactly as your doctor prescribes. Eat a healthy diet. If you are overweight, ask your doctor to help you lose weight. Get plenty of exercise.

Here are some other ways to protect your feet:

  • Wash your feet every day with lukewarm (not hot) water and mild soap.
  • Dry your feet well, especially between the toes. Use a soft towel and pat gently; don’t rub.
  • Keep the skin of your feet smooth by applying a small amount of cream or lotion, especially on the heels. If the skin is cracked, talk to your doctor about how to treat it.
  • Check your feet every day. You may need a mirror to look at the bottoms of your feet. Call your doctor if you have redness, swelling, pain that doesn’t go away, numbness, or tingling in any part of your foot.
  • Don’t treat calluses, corns, or bunions without talking to your doctor first.
  • Cut toenails straight across to avoid ingrown toenails. It might help to soak your toenails in warm water to soften them before you cut them. File the edges of your toenails carefully.
  • Don’t let your feet get too hot or too cold.
  • Don’t go barefoot.

When choosing shoes and socks, use these guidelines:

  • Don’t wear shoes without socks.
  • Don’t wear sandals or other open-toed shoes.
  • Avoid high-heeled shoes and shoes with pointed toes.
  • Wear comfortable socks that aren’t too tight. Change them every day.
  • Don’t wear uncomfortable or tight shoes that rub or cut into your feet. If you’ve had problems before because of shoes that didn’t fit, you may want to be fitted for a custom-molded shoe.
  • Talk to your doctor before you buy special shoes or inserts.
  • Shop for new shoes at the end of the day when your feet are a little swollen. If shoes are comfortable when your feet are swollen, they’ll probably be comfortable all day.
  • Break in new shoes gradually.
  • Look inside your shoes every day for things like gravel or torn linings. These things could rub against your feet and cause blisters or sores.

Diabetic neuropathy treatment

There is no cure for diabetic neuropathy. Treatment focuses on slowing the development of the condition. You can do this by controlling blood sugar levels and making lifestyle changes. These lifestyle changes not only help slow nerve damage, but also promote overall health. They include:

  • Eating a healthy diet
  • Exercising regularly
  • Maintaining a healthy weight
  • Controlling blood pressure
  • Not smoking
  • Limiting alcohol use

Treatment for diabetic neuropathy also focuses on relieving pain and discomfort. There are several medicines available that help ease neuropathy pain. Your doctor will help you decide which is the best for you.

Living with diabetic neuropathy

Taking good care of your feet is critical when you have diabetic neuropathy. Try to prevent injuries to your feet. Exercise to help keep muscles strong. Pay special attention if you see a crack or sore on either of your feet. Keep your skin dry. Apply a small amount of lotion to your feet each day to keep your skin soft and reduce cracking. If you are having any problems, such as increased numbness, sores, or ingrown toenails, tell your doctor right away.

Questions to ask your doctor

  • I haven’t been diagnosed with diabetes, but my feet are numb and sometimes tingle. Should I be tested for diabetes?
  • Do I really need to adjust my footwear?
  • If I get a sore on my foot, should I see my doctor immediately, or is it okay to monitor it myself?
  • Can you recommend a good lotion for my feet?
  • Will my neuropathy ever get better?
  • Are there any medicines I can take to stop the pain?
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