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Diabetic Peripheral Neuropathy: How Diabetes Affects Your Nerves

Numbness or pain in your toes or feet can be a sign of nerve damage.

older man talking to his doctor

Nerves play an important role in your body. They signal your brain to sense pain, temperature and touch. They run throughout your system, telling your muscles when to move. Nerves help you breathe, swallow and digest your food — and can even be involved with how fast your heart beats.

When your blood sugar remains high over time, as it can with diabetes, damage to nerves may occur. This damage is called neuropathy, and there are several types. Over time, the damage may spread into the legs or arms, or even into the body’s organs.

The most common type of diabetic nerve damage is called peripheral neuropathy which affects the nerves in the upper or lower extremities.

It’s estimated that more than half of those with diabetes have some form of nerve damage. It is seen more often in people who have had diabetes for a number of years.

You should be screened for peripheral neuropathy when you are diagnosed with type 2 diabetes. If you have been diagnosed with type 1 diabetes, you should get the screening five years later. In both cases, you should get at least annual screenings after that.

Common symptoms

Peripheral neuropathy may first be felt as pain, burning, tingling or numbness in the toes or feet. You might be extremely sensitive to touch. You may have more discomfort when you’re resting, but feel better when you’re moving about. Nerves are typically affected on both sides of the body.

If the damage progresses, you may lose the ability to sense pain. You might develop a cut or blister on your feet and not even realize it. A small ulcer or infection can develop into a big one, possibly leading to amputation of a toe or foot.


You may be able to stop peripheral neuropathy from getting worse or even prevent it. There are also ways to relieve any pain. Here are some smart steps to follow:

  • Practice good blood sugar control. Keep your glucose levels in your target range. Follow your plan for healthy eating, regular physical activity and medications, if prescribed. Using a blood glucose monitor can help keep you on track. Make sure you get an A1C lab test at least twice a year to track your most recent months of blood sugar control.
  • Report any discomfort, pain or injury. Discuss a daily foot care routine with your doctor and stick to it. Make sure any exercise you do is safe, especially if you’ve lost some feeling in your feet or legs — but be as active as you can. Be careful in extreme temperatures.
  • Discuss medications. Several types of medicines may help with pain. But each may have pros and cons. Even over-the-counter pain meds can have side effects. So talk with your doctor about what might be best for you. Some people find relief through alternative treatments like acupuncture.
  • Don’t smoke. If you do, take immediate steps to quit.
  • Stay at a healthy weight. If you’re overweight or obese, you are at higher risk of some nerve damage.

Taking care of your health and getting proper care can help you prevent or delay more nerve damage and reduce symptoms.

By Ginny Greene, Contributing Editor

American Diabetes Association. Standards of medical care in diabetes–2015. Accessed: October 23, 2015.
National Diabetes Information Clearinghouse. Diabetic neuropathies: The nerve damage of diabetes. Accessed: October 23, 2015.
American Diabetes Association. Neuropathy (nerve damage). Accessed: October 23, 2015.
American Diabetes Association. Neuropathy (nerve damage). Steps to prevent or delay nerve damage. Accessed: October 23, 2015.

Last Updated: October 23, 2015