Nerve Damage (Diabetic Peripheral Neuropathy)


Diabetic peripheral neuropathy is a long-term complication of diabetes. Exposure to high blood glucose levels over a long period of time causes damage to the peripheral nerves – the nerves that go to hands, the arms, legs, and feet.

Symptoms of diabetic peripheral neuropathy

Although diabetic peripheral neuropathy can occur in many places in the body, the most common symptoms are abnormal sensations in the toes and feet, including:

  • Sharp, shooting pains
  • Burning
  • Tingling
  • A feeling of being pricked with pins
  • Throbbing
  • Numbness (not able to properly feel pain, heat, or cold)

Diabetic peripheral neuropathy increases the risk for foot ulcers and amputation. Due to nerve damage in their own feet and toes, individuals with diabetes that have diabetic peripheral neuropathy frequently do not find small cuts, sores, or blisters in these regions. If left untreated, these small wounds can easily become infected, lead to gangrene, and may eventually require amputation of the affected area.

Risk factors for diabetic peripheral neuropathy

Risk factors for diabetic peripheral neuropathy include:

  • High blood glucose (sugar) levels
  • Elevated triglycerides
  • Excess body weight
  • Smoking
  • High blood pressure

Diagnosing diabetic peripheral neuropathy in the feet

Your physician or foot care specialist can examine for diabetic peripheral neuropathy by lightly pressing a thin nylon stick (10-gram monofilament) to different areas of your foot (in particular, your big toe) or by using the 128-Hz tuning fork on the rear of the big toe to find out if you can feel it. These are simple and pain free evaluations.

When to screen for diabetic peripheral neuropathy

For type 1 diabetes

  • Because diabetic peripheral neuropathy is uncommon within the first five years after onset of type 1 diabetes, annual screening for diabetic peripheral neuropathy should begin after five years of diabetes diagnosis.
  • For children with type 1 diabetes, screening should be done once the child is past puberty and has had diabetes for at least five years.

For type 2 diabetes

  • For people with type 2 diabetes, screening for diabetic peripheral neuropathy should begin right away, at diagnosis of diabetes, and every year after that.

How can I prevent complications of diabetic peripheral neuropathy?

Although there is no cure, there are many ways you can effectively manage diabetic peripheral neuropathy.

Proper foot care

  • Examine your feet and legs daily.
  • Care for you nails regularly.
  • Apply lotion if your feet are dry (but not between the toes).
  • Wear properly fitting footwear.
  • Test your bath water before you step in to make sure it’s not too hot.
  • Do not soak your feet.

Excellent blood glucose control

  • Managing your blood glucose levels effectively can help to prevent further nerve damage.


  • Some medications that act on the nerves, can be helpful.
  • Ask your doctor what would be best for you diabetes.