Diabetic neuropathy is a common complication of diabetes that can cause foot pain and numbness in the toes. This blog post will explain what diabetic neuropathy is, symptoms to look out for, complications, and how it can be cured.

In this Diabetic & Me Article you will learn about:

  • What is neuropathy?
  • What are the different types of neuropathy?
  • Are there symptoms I need to watch out for?
  • What are the causes, the diagnosis, and treatment for diabetic neuropathy?

What is diabetic neuropathy?

Diabetic neuropathy is a common complication of diabetes that can cause foot pain and numbness in the toes. It is caused by damage to small nerve pathways (neuropathy) in your feet, which leads to a reduced feeling of touch or sensation on certain parts of the body.

Diabetes causes diabetic neuropathy because high blood sugar levels make it difficult for healthy cells to function well enough so they can communicate with other cells throughout the body, including those in your feet. This lack of communication between healthy cells then damages nerves - causing diabetic foot complications.

It's very important that you take care of your feet otherwise diabetic neuropathy can intensify and lead to complications such as ulcers and sores that don't heal easily due to the reduced feeling of touch or sensation on certain parts of your feet.

To improve the feeling in your feet make sure you take care of them you can always use a soothing foot cream or give your heels more support with shoes for diabetics or specialised inserts for your shoes.

What are the different types of diabetic neuropathy?

Peripheral neuropathy

This type of neuropathy is the most common and mainly affects a person’s hands and feet. It happens when high blood sugar levels disrupt how nerves communicate with one another, which then leads to nerve damage in your extremities.

This type of neuropathy is usually painless but can be severe enough to make walking difficult because it causes tingling sensations or numbness that makes you less aware of where your body parts are in relation to other objects such as curbs, sidewalks, and stairs.

It also takes longer for people suffering from peripheral neuropathy to heal after an injury - sometimes up to six weeks instead of two days like someone without this condition would experience. This means wounds take much longer than usual before they start healing and chronic conditions worsen.

Autonomic neuropathy

The autonomic nervous system controls involuntary body processes such as digestion, sweating, and heart rate. Autonomic neuropathy is also a form of diabetic nerve damage that can cause serious health problems.

If you have diabetes it may be difficult to tell if this type of neuropathy has developed because there are no noticeable symptoms in the beginning stages (early autonomic neuropathy), which makes it more likely for people with this condition to ignore what's happening inside their bodies.

Signs include difficulty swallowing or breathing due to an uncoordinated esophagus, impaired control over bladder muscles leading to accidental urinary incontinence, slow heartbeat when sitting up against gravity compared with lying down on your back, and nausea or vomiting after eating certain foods like pie crust or pizza dough because those are pretty heavy.

Proximal neuropathy

This type of neuropathy is mostly found in the nerves in the thighs, hips, buttocks, or legs. It can cause sharp pain or pins-and-needles sensations due to nerve damage in these parts of the body.


There are two types of mononeuropathy, cranial and peripheral. Cranial mononeuropathy affects the nerves in your head, while peripheral causes nerve damage in the limbs or torso.

Mononeuropathy can result from injuries to a single axon that transmits messages along its length down one side of the body (unlike polyneuropathies where multiple axons are damaged). Mononeuropathic pain is often stabbing and severe as opposed to dull, throbbing sensations caused by polyneuritis.

The most common cause of mononeuropathy is diabetic neuropathy which occurs when there's insufficient insulin for sugar-fueled blood vessels inside our bodies to provide proper nourishment. This lack of nourishment leads to poor circulation and increased pressure on nearby neurons.

What are the symptoms of diabetic neuropathy?

The main symptoms are pain in the feet, numbness in the toes or foot, and pain while walking. But the symptoms are different depending on the type of neuropathy you have. One of the most common types is peripheral neuropathy.

Peripheral neuropathy is a type of neuropathy that happens when there is nerve damage to the peripheral nerves.

This type of neuropathy usually affects both sides of your body, in different areas at different times such as:

  • pain that spreads into your legs and hands or feet
  • tightness or tingling sensations in any parts of your body
  • a pins and needles sensation where you may feel like an electric shock passed through the area. It can feel like a pain or cramp.
  • numbness or reduced nerve sensitivity

It can also lead to eventual lesions on the skin called "carpal tunnel syndrome" which causes numbness, weakness, burning pains, cramps, and more. It's more common among people who work with repetitive motions such as typing for long periods of time without taking breaks. 

What causes diabetic neuropathy?

It's yet not sure how diabetic neuropathy is caused but it's speculated that the causes are either uncontrolled high blood sugar or still unknown.

Diabetic patients with long-term diabetes can experience complications in nerve function, including loss of feeling and changes to their sense of taste. They may also have difficulty regulating body temperature as a result of poor circulation.

The risk factors for developing complications like neuropathy from diabetes may be genetic, environmental (obesity), metabolic disturbances and poor glycemic control. In addition to nerve damage, experiencing frequent episodes of hypoglycemia can also cause neuronal dysfunction. 

Poor glycemic control

There are multiple risk factors for developing diabetic neuropathy and one of the most important is poor glycemic control. Poorly managed diabetes can affect how nerves function by reducing or eliminating blood flow to them, an effect that may happen as a result of high glucose levels in the bloodstream over time.

The length of your diabetes

The length of your diabetes can also play a role in the development of diabetic neuropathy. The longer you have had diabetes, the higher risk there is for developing complications like this one. The most common form of neuropathy that develops from poorly managed diabetes are called focal or segmental mononeuropathies and affect only certain nerves in parts of your body.

Kidney complications

The kidneys are the organs that filter blood and retain useful materials like glucose. Diabetic neuropathy is often linked to kidney complications because high levels of sugar in your bloodstream can damage these important filtering machines.


Being overweight can also cause complications. One of the most common reasons for increased risk is because diabetes affects your body's ability to produce or distribute insulin, which can lead to high blood sugar levels.

Overweight individuals are more likely than others who are not overweight to have these symptoms and complications caused by diabetic neuropathy.

Smoking cigarettes

You should avoid smoking cigarettes or other tobacco products because they can worsen complications. They are bad for your blood flow and arteries. They reduce the amount of blood that flows to your limbs and cause issues to your peripheral nerves. 

How is diabetic neuropathy diagnosed?

It's always important to let a doctor diagnose you for neuropathy. A neurologist will usually diagnose diabetic neuropathy in adults and a pediatrician or pediatric endocrinologist may diagnose it in children.

You should be aware of the symptoms, such as: numbness, tingling sensations, muscle weakness, burning pain to your feet and hands. These are all signs that you might have complications from diabetes-related neuropathy. To diagnosis this yourself without medical professionals is very difficult because many other problems can cause similar symptoms on their own (like Vitamin B12 deficiency).

The doctor will also ask questions about whether you've had peripheral nerve injury due to past trauma or surgery before diagnosing with diabetes-related neuropathy. They may do tests like an electrodiagnostic study which involves nerve functions tests.

Blood tests, nerve and skin biopsy are also research a doctor will do to diagnose your neuropathy.

How is diabetic neuropathy treated?

There are different ways to cure diabetic neuropathy. Sometimes, the treatment includes medication and physical therapy. There are also options for surgery or a diabetic nerve specialist.

Most treatments to cure neuropathy include taking diabetes medications like metformin (Glucophage) and insulin injections on a daily basis to help reduce blood sugar levels in order to prevent further damage of nerves from high glucose levels.

Physical therapy is also recommended as it helps with strengthening muscles which will aid in walking. Other medical interventions may be necessary depending on the severity of your symptoms such as surgical intervention, chemotherapy drugs, or even amputation if limbs have been paralyzed because of severe neuropathy pain that does not respond well to other methods

The main goal of all these treatments is relief from chronic pain caused by neuropathy.

There are several medications and therapies you can follow. More in depth information about these can be found on the Mayo Clinic .

Can I prevent diabetic neuropathy?

Yes, there a various way to prevent and help you manage diabetic neuropathy.

These preventative therapies include:

  • Physical therapy to help relieve the symptoms of neuropathy and manage pain.
  • Limiting or stopping alcohol intake, which may be one cause of diabetic neuropathy. Alcohol can lead to nerve damage as well.
  • Eating a healthy diet with less sugar that is low in fat, cholesterol, and salt so it's easier on your blood pressure levels if you have hypertension (high blood pressure)that may contribute to neurological disorders such as diabetes mellitus type 2. If you don't already have high blood pressure, this will lower your risk for developing it later in life because chronic conditions like these usually worsen over time without treatment. This also prevents complications from arising due to uncontrolled high blood sugar.
  • Managing your blood sugar levels is an important step in preventing complications and treating the symptoms of diabetic neuropathy. Make sure you check your blood sugar levels daily with a blood glucose monitor.
  • Eating a diet rich in omega-three fatty acids, which can help prevent neurological disorders like diabetic neuropathy due to helping with blood sugar levels.
  • The best way to prevent diabetic neuropathy from worsening and lead to complications is to take care of your feet. This can be done by using different types of insoles, wearing proper shoes for your condition, and applying foot creams on the areas that are hurting. 

Why is foot care so important?

Diabetes can lead to foot complications, and controlling your blood sugar levels is the best way to prevent foot complications. You have a higher chance of getting diabetic neuropathy if you are not managing your diabetes well, so it's important to take care of yourself!

To take care of your feet at home you can wear proper shoes for your condition, like diabetic shoes or orthopedic shoes with insoles.

You can also use foot creams on areas that are hurting to soothe any pain caused by neuropathy. The last thing you want is to walk around in excruciating pain because of something that could have been prevented!

If you're planning on being out and about this summer make sure you wear good quality sandals or flip-flops when possible as well as always wearing socks. This will help prevent getting a blister which may lead to an infection since we'll be sweating more than normal outdoors too!

Don't forget to check your feet daily for for blisters, cuts, bruises, cracked and peeling skin, redness, and swelling. 


Diabetic neuropathy is a complication of diabetes that can cause foot pain and numbness in the toes. It occurs when there is damage to small nerve pathways (neuropathy) in your feet, which leads to a reduced feeling of touch or sensation on certain parts of the body. The most important thing you can do if you have this condition is to make sure you take care of yourself by maintaining healthy blood sugar levels with regular exercise, eating healthier foods, getting enough sleep each night, and taking medications as prescribed.

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About the Author

Ely Fornoville

Hi, I'm Ely Fornoville, and I am the founder of Diabetic Me. Being a type 1 diabetic since 1996, I developed a passion to help people learn more about diabetes. I write about diabetes and share stories from other diabetics around the world. I currently use a Medtronic Guardian 4 CGM and a MiniMed 780G insulin pump with Humalog insulin.

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