Diabetes Education

Diabetic Neuropathy

Diabetic neuropathy is one of the most common conditions that affects people with diabetes. Learn about the four types of diabetic neuropathy, as well as its causes, symptoms, and treatment.

Diabetic neuropathy refers to the nerve damage caused by diabetes. While there are many contributing risk factors for neuropathy, such as inherited traits and injuries, high blood glucose levels are likely a main cause of this condition. Diabetic neuropathy is still being studied, but it is believed to be affected by low levels of insulin, unusual blood fat levels, and the long-term nature of diabetes.

There are four main classifications of diabetic neuropathy, and each one affects different parts of the body.

1. Peripheral neuropathy affects the legs, feet, and toes, and to a lesser extent, the arms and hands. Peripheral neuropathy causes pain or loss of feeling in the affected areas. Some people with diabetes experience burning or prickling sensations, become very sensitive to touch, or lose balance or coordination. Foot injuries must be given particular attention for people with peripheral neuropathy.

2. Autonomic neuropathy has many varied effects, especially on the heart and blood vessels, the digestive system, the urinary tract, sex organs, sweat glands, and the eyes. Autonomic neuropathy can affect blood pressure, sexual activity, and normal functioning of the bowel and bladder. This condition may also cause people with diabetes to be unable to recognize the symptoms of low blood sugar. Autonomic neuropathy may cause weight loss, a sustained high heart rate, and reduced night vision.

3. Proximal neuropathy affects the thighs, hips, and buttocks. Diabetics may experience pain and a weakening of the legs. Proximal neuropathy is more common in Type 2 diabetes and in older people who have diabetes.

4. Focal neuropathy generally affects the eyes, face, ears, pelvis, lower back, thighs, and abdomen, though any nerve in the body may experience focal neuropathy. This condition causes weakness or pain in muscles due to the weakening of the affected nerve(s). It is most common in older people who have diabetes, but does not cause long-term damage and is self-healing over time.

To prevent diabetic neuropathy, your best course of action is to keep your blood sugar levels under control to prevent nerve damage. In addition, diabetic neuropathy may be treated with many methods:

  • Proper foot care, including daily inspection for injuries.
  • Pain relievers, hypnosis, acupuncture, and other pain-relieving methods.
  • Medication for digestive problems.
  • Eating small, frequent meals that are lower in fat and fiber, or other diet modifications as specified by your doctor.
  • Wearing elastic stockings to improve circulation.
  • Antibiotics to clear up infections and to help regulate digestive problems.
  • Medications to increase sexual function.

Marci Sloane, MS, RD, LD/N, CDE

Article was reviewed by Marci Sloane, a registered and licensed dietitian/nutritionist and certified diabetes educator. Marci graduated with a degree in Nutrition and Physiology from Teachers College at Columbia University. Marci manages a Diabetes and Nutrition Education Center in South Florida and is the author of The Diet Game: Playing for Life!

The goal of Destination Diabetes® is to be a useful and credible resource for the more than 20 million children and adults who have diabetes in the U.S. and their families. Destination Diabetes® provides information on a wide range of diabetes health and wellness topics. Articles are written or reviewed by diabetes advisors who have experience in diabetes education.