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Diabetic neuropathy

Detail level

Long-term high blood sugar can damage nerves, causing numbness, tingling or pain in the feet and hands, and sometimes affecting internal organs such as the heart, bladder and digestion.

The NIDDK states that between a third and a half of people with diabetes have peripheral neuropathy. Symptoms differ by type: peripheral (feet, legs and hands), autonomic (heart, blood pressure, digestion and bladder), focal (a single nerve, such as carpal tunnel syndrome), and proximal (hip and thigh).

Nerve damage is linked to high glucose and triglycerides. Autonomic neuropathy may cause not feeling hypoglycaemia. Management includes controlling sugar, nerve pain medicines, physiotherapy and mobility aids (NHS). The feet need regular examination to detect complications early.

In one minute12

What is it?
Nerve damage caused by diabetes.
Who is usually affected?
Affects between a third and a half of people with diabetes in the peripheral type according to NIDDK.
Acute or chronic?
Progresses over time; some types, such as proximal, improve gradually.
Main symptoms
Numbness, tingling and burning pain in the feet, and poor balance; symptoms in the heart, digestion and bladder in the autonomic type.
Red flags?
Yes: a foot wound that does not heal.
Preventable?
Control blood sugar and care for the feet.

What is it?

It is nerve damage caused by diabetes; high glucose and triglycerides harm the nerves over time, and symptoms differ by type.

According to NIDDK: between a third and a half of people with diabetes have peripheral neuropathy. The NHS states that diabetes is the most common cause of peripheral neuropathy in the United Kingdom.

Sources12

Causes

The cause here is chronic high blood sugar. Peripheral neuropathy in general also has causes including nerve injuries, viral infections such as shingles, effects of some medicines, and excessive alcohol.

Sources12

Symptoms

Peripheral type: tingling and numbness in the feet or hands, burning or stabbing pain, loss of balance, and muscle weakness especially in the feet.

Autonomic type: damages the nerves of internal organs, affecting heart rate, blood pressure, digestion, bladder, sexual function and sweat glands, and may cause not feeling hypoglycaemia.

The focal type affects a single nerve and the best known is carpal tunnel syndrome; the proximal type is rare and affects the hip and thigh usually on one side and improves gradually over months or years.

Sources21

How is it diagnosed?

Foot examinations and other tests determined by the doctor are done; this page's sources do not detail a particular test.

Sources1

Treatment

The treatment categories usually used are listed here; this is not a prescription. The doctor chooses the plan according to each person's condition; do not change any medicine or dose without a specialist.

Treating the cause by controlling blood sugar, nerve pain medicines, physiotherapy for muscle weakness, and mobility aids. No doses are given.

Strength of evidence: Moderate evidence

Why this rating: Based on guidance pages from major health bodies (WHO, NHS and NIH) that have not been systematically appraised here; it will be reviewed with a medical reviewer before the grade is raised.

The true effect is probably close to the estimate, but new research could change it.

Sources2

Follow-up

People with diabetes need regular periodic checks according to the NHS.

Sources2

Prevention

Control blood sugar and care for the feet to limit nerve damage and its complications.

Strength of evidence: Moderate evidence

Why this rating: Based on guidance pages from major health bodies (WHO, NHS and NIH) that have not been systematically appraised here; it will be reviewed with a medical reviewer before the grade is raised.

The true effect is probably close to the estimate, but new research could change it.

Sources1

When do you need urgent help?

Get urgent care today

  • A wound or ulcer on the foot with redness, warmth, swelling or discharge.34

See your doctor within days

  • Pain, tingling or loss of sensation in the feet, or loss of balance, or a wound that does not heal: see the doctor.2

Educational content only — no diagnosis, and no substitute for a clinician.

Common questions

Does diabetic neuropathy affect only the feet?

No. The peripheral type affects the feet and legs and sometimes the hands, but there are types that affect internal organs (autonomic), a single nerve (focal), or the hip and thigh (proximal).1

Questions for your doctor

  • What type of neuropathy do I have?
  • Do I need a nerve pain medicine and what are its side effects?
  • How do I examine and protect my feet?
  • Does autonomic neuropathy affect my awareness of hypoglycaemia?
  • Do I need physiotherapy?

References

  1. 1 Health agencies & guidelines · Accessed 2026-10-03
  2. 2 Health agencies & guidelines · Accessed 2026-10-06
  3. 3 Health agencies & guidelines · Accessed 2026-10-03
  4. 4
    MedlinePlus / NLM. Diabetes — foot ulcers. medlineplus.gov/ency/patientinstructions/000077.htm
    Health agencies & guidelines · Accessed 2026-10-06

Review status: Edited content · Last updated:

Change log
  • — Page created.

Educational content only — no diagnosis, and no substitute for a clinician.

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