Diabetes Health Center

Peripheral Neuropathy and Diabetes

Peripheral neuropathy is nerve damage caused by chronically high blood sugar and diabetes. It leads to numbness, loss of sensation, and sometimes pain in your feet, legs, or hands. It is the most common complication of diabetes.

About 60% to 70% of all people with diabetes will eventually develop peripheral neuropathy, although not all suffer pain. Yet this nerve damage is not inevitable. Studies have shown that people with diabetes can reduce their risk of developing nerve damage by keeping their blood sugar levels as close to normal as possible.

What causes peripheral neuropathy? Chronically high blood sugar levels damage nerves not only in your extremities but also in other parts of your body. These damaged nerves cannot effectively carry messages between the brain and other parts of the body.

This means you may not feel heat, cold, or pain in your feet, legs, or hands. If you get a cut or sore on your foot, you may not know it, which is why it's so important to inspect your feet daily. If a shoe doesn't fit properly, you could even develop a foot ulcer and not know it.

"The consequences can be extraordinarily devastating and life-threatening," Tom Elasy, MD, director of the Diabetes Clinic at Vanderbilt University in Nashville. "An infection that will not heal because of poor blood flow causes risk for developing ulcers and can lead to amputation, even death."

This nerve damage shows itself differently in each person. Some people feel tingling, then later feel pain. Other people lose the feeling in fingers and toes; they have numbness. These changes happen slowly over a period of years, so you might not even notice it.

"It's not like you wake up one morning and feel it," Elasy says. "The changes are very subtle. And because it happens as people get older, they tend to ignore the little tingles or subtle loss of sensation that is occurring -- the signs of nerve damage. They think it's just part of getting older."

But there are treatments that can help slow the progression of this condition and limit the damage. "We have a lot of options for management of this condition," Elasy says. "Don't be too stoic. Talk to your doctors about it. This is important stuff."

"But the bad news is, it can get worse," he says. "If you've got tingling now, in 10 years it can be painful -- if you don't address it now."

Symptoms of Nerve Damage From Diabetes

Numbness is the most common, troubling symptom of nerve damage due to diabetes, Elasy says. "People who lose sensation are of special concern. They're the ones who get ulcers on their feet -- who can end up needing amputations."

People describe the early symptoms of peripheral neuropathy in many ways:

• Numbness
• Tingling
• Pins and needles
• Prickling
• Burning
• Cold
• Pinching
• Buzzing
• Sharp
• Deep stabs