Diabetic Neuropathy



Diabetic neuropathy is likely caused by a mix of things, such as:

  • Metabolic factors like:
  • Elevated blood pressure
  • High blood glucose
  • Longer duration of diabetes
  • High cholesterol
  • Possibly low levels of insulin
  • Damage to blood vessels going to nerves
  • Autoimmune factors causing inflammation of nerves
  • Nerve trauma
  • Genetics
  • Smoking or alcohol abuse

Risk Factors

Diabetic neuropathy is more common in older adults.

Things that may raise the risk include:

  • Having diabetes for 25 years or more
  • Having type 2 diabetes
  • High blood pressure
  • Obesity
  • Lack of exercise
  • Peripheral artery disease (PAD)
  • High cholesterol



Symptoms of diabetic neuropathy may include:

  • Numbness, tingling, or pain in the extremities
  • Digestive problems, such as:
  • Stomach fullness or discomfort after eating
  • Nausea or vomiting
  • Loose stools (poop) or stools that are hard to pass
  • Lightheadedness
  • Urination (peeing) problems
  • Erectile dysfunction or vaginal dryness
  • Problems with muscles, such as:
  • Weakness of face muscles
  • Problems swallowing
  • Weakness in the arms and/or legs
  • Muscle cramps
  • Less sweating
  • Blurred or double vision

Other neuropathies may also happen, such as carpal tunnel syndrome.

Diabetic neuropathy can lead to serious problems, such as:

  • Foot ulcers
  • Infection
  • Limb loss


The doctor will ask about symptoms and past health. A physical exam will be done. A foot exam will also be done.

Tests will be done to make the diagnosis and rule out other causes. Tests will depend on the specific problems. They may include:

  • Blood tests—to look for abnormalities
  • Nerve function tests, such as:
  • Nerve conduction studies
  • Electromyography
  • Imaging of body structures with:
  • Magnetic resonance neurography (MRN)
  • Ultrasound
  • Barium study of stomach—to check for a blockage
  • Electrocardiography (ECG)—to check for heart effects
  • Biopsy—to test the nerves



Treatment may include:

Blood Glucose Management

It is important to regularly monitor blood glucose levels. Meal planning, exercise, and/or medicines can help.

Foot Care

Footcare will be needed to avoid foot ulcers. The nerves in the feet are the ones most often affected by neuropathy. This care will involve:

  • Regular visits to a foot doctor
  • Careful cleaning, checking, moisturizing, and grooming of the feet
  • Wearing well-fitting shoes and thick, soft, seamless socks—to protect feet


Nerve decompression surgery may be done to reduce pain.

Other Treatments

Other treatments will depend on symptoms. Options may include:

  • Medicines to ease pain, burning, tingling, or numbness from peripheral neuropathy
  • Transcutaneous electrical nerve stimulation (TENS)—to ease pain from nerve damage
  • Medicines to control any digestive, heart, or urinary symptoms
  • Other activities to help improve symptoms and coping, such as:
  • Counseling
  • Relaxation methods, such as mindfulness, yoga, massage
  • Physical activities, such as Tai Chi


To help prevent diabetic neuropathy, regularly check and manage:

  • Blood glucose levels
  • Blood pressure
  • Cholesterol levels

The doctor can tell you how often to do this and what the numbers mean.

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

Edits to original content made by Denver Health.