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Diabetic Neuropathy: Understanding Nerve Damage in Diabetes

Posted by:

Johannes Sauer

Published at: June 14, 2024

Table of Contents
  1. What is Diabetic Neuropathy?

  2. Types of Diabetic Neuropathy

    1. Peripheral Neuropathy

    2. Autonomic Neuropathy

    3. Focal Neuropathy

  3. Symptoms of Diabetic Neuropathy

    1. Numbness

    2. Digestive Issues

    3. Cramps

  4. Causes of Diabetic Neuropathy

    1. High Blood Pressure and Cholesterol Levels

    2. Lifestyle Factors

    3. Physical Injuries

  5. Diabetic Neuropathy Diagnosis

  6. How to Improve Your Diabetic Neuropathy

    1. Lifestyle Changes to Manage Diabetic Neuropathy

If you have diabetes and are experiencing pain, tingling or numbness in your legs and feet, and possibly your hands and arms, you likely are experiencing a nerve damage condition called diabetic neuropathy. What is diabetic neuropathy?

While diabetic neuropathy can have an adverse effect on your quality of life, there are steps you can take to manage it once you receive a diagnosis.

What is Diabetic Neuropathy?

Diabetic neuropathy is a type of nerve damage that can occur if you have diabetes. It is a result of the chronically elevated blood sugar levels that come with this disease. Mayo Clinic reports that around half of people with diabetes develop diabetic neuropathy.

Types of Diabetic Neuropathy

There are several different types of diabetic neuropathy. These include peripheral neuropathy, autonomic neuropathy and focal neuropathy.

Peripheral Neuropathy

The most common form of diabetic neuropathy is peripheral neuropathy, which is also referred to as distal symmetric peripheral neuropathy. It is a type of nerve damage that produces symptoms first in the feet and legs, and then in the hands and arms as well. 

Some symptoms you may experience with peripheral neuropathy include burning, tingling, numbness, reduced temperature sensations, cramping and heightened sensitivity. More serious problems such as foot ulcers may also develop.

Autonomic Neuropathy

This type of neuropathy can affect a wide range of organs that are regulated by the autonomic nervous system. People who are experiencing autonomic neuropathy may experience symptoms such as blood pressure drops, difficulty swallowing, vision problems, bladder problems, bowel problems, poor blood sugar awareness, unusual sweating, erectile dysfunction, or vaginal dryness.

Focal Neuropathy

Another word for this type of neuropathy is mononeuropathy. “Mono” here means “one.” Focal neuropathy affects just one nerve, most commonly in the arm, leg, torso or face.

Possible symptoms include pain, weakness, numbness, tingling, paralysis or vision problems.

Symptoms of Diabetic Neuropathy

As we have discussed above, the symptoms for neuropathy depend on which type of diabetic neuropathy you have and its location. Neuropathy symptoms can be mild, moderate or severe. They can come and go, or they can be constant and intractable. Let’s discuss a few of the common symptoms in a little more detail.


For many people, numbness is one of the most problematic symptoms of diabetic neuropathy. Not only can numbness be unpleasant from a sensory standpoint, but it can make it hard to do some everyday tasks.

For example, if you have numbness in your feet, you may have a difficult time lifting your feet while you walk to maintain a natural gait. You might be prone to tripping and falling, or might not notice if you hurt your feet while you are walking.

Digestive Issues

Sometimes diabetic neuropathy affects a nerve in the digestive system. When this happens, it can result in a few different digestive problems such as constipation, diarrhea, or gastroparesis (slow stomach emptying). When the stomach empties slowly, you may experience symptoms such as indigestion and bloating.


When neuropathy affects muscles, such as those in your feet, you might experience cramping. The pain associated with cramps can be sharp and unpleasant. And as with numbness, it can sometimes be difficult to go about your daily tasks when you are experiencing cramps.

Causes of Diabetic Neuropathy

Let’s talk a bit more about what actually causes diabetic neuropathy.

High Blood Pressure and Cholesterol Levels

Patients with high blood pressure and cholesterol can sometimes go on to develop insulin resistance and type-2 diabetes. Once diabetes develops, blood sugar may be chronically high, which can cause the nerve damage that results in diabetic neuropathy.

Lifestyle Factors

If you are eating an unhealthy diet, not exercising, and are overweight, those are all factors that can increase your chances of experiencing diabetic neuropathy. Smoking is another risk factor for this type of nerve damage. 

Luckily, those are all things you can do something about. Adopting a healthy diet and exercise routine, and not smoking can help.

Physical Injuries

Jun 14, 2024

Peripheral neuropathy can be caused by physically injuring the nerves as well. So, that is one more cause to keep in mind.

Diabetic Neuropathy Diagnosis

When you visit your doctor for a diagnosis, they will begin by giving you a basic physical exam and asking you questions to assess your symptoms and medical history.

Sometimes, additional testing may be necessary. Some types of diagnostic tests that can be used to identify diabetic neuropathy include filament testing, sensory testing, nerve conduction testing, electromyography and autonomic testing.

How to Improve Your Diabetic Neuropathy

There is no way to cure diabetic neuropathy right now. But there are things you can do to help you manage your condition. After your diagnosis, your doctor will work with you to create a personalized treatment plan.

To start, you will need to treat the diabetes itself. Your doctor will help you establish a target blood sugar level.

While you are treating the diabetes, you may be given pain medications for the neuropathy symptoms. Most commonly, these may include antidepressants and anti-seizure drugs. 

If you have a type of neuropathy that is affecting organ function, you may be given medications to improve urinary function, digestive function, sexual function, and/or blood pressure, depending on your symptoms.

Lifestyle Changes to Manage Diabetic Neuropathy

Your doctor will advise you to make some changes to your lifestyle, including eating a healthy diet rich in fruits, vegetables and whole grains, and maintaining a regular exercise routine. If you currently smoke, you will need to stop. 

Exercising when you have peripheral neuropathy may sound intimidating, since pain and numbness can interfere with your comfort and your gait. 

One solution is to shop for shoes designed for patients with neuropathy. Cadense Original Adaptive Shoes for men and women with patented variable friction technology make it easier to walk with neuropathy by helping the wearer “glide” across obstacles and uneven surfaces, even if they cannot completely lift their feet due to numbness and foot drop.

These shoes offer some additional advantages for people with diabetic neuropathy as well. They are comfortably cushioned, and fit snugly without restricting blood flow. Their lightweight materials reduce fatigue so you can exercise for longer without fatiguing.

When the right shoes are making walking safer and more enjoyable, it becomes easier to motivate yourself to keep exercising.

As you make workouts a regular part of your routine, you may start experiencing improvements in your health. The CDC explains that your insulin sensitivity increases when you live an active lifestyle. It can also help you maintain healthy blood sugar levels. 

As a result, you can help keep your diabetes in check. Your risk of future nerve damage decreases along with your risk of heart disease. 

If you do not yet have diabetes, but are pre-diabetic, exercising can help you reduce your risk of developing this disease.

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Who is at risk of developing diabetic neuropathy?

Since diabetic neuropathy affects around half of patients with diabetes, simply having diabetes puts you at risk for this condition. That risk increases if you do not maintain a healthy weight or if you smoke.

What are the treatment options for diabetic neuropathy?

Treating diabetic neuropathy requires a combination of treating the underlying diabetes, and treating the neuropathy itself.

You may be prescribed medications to help you manage your neuropathy symptoms, along with lifestyle changes such as improved diet and exercise.

How can individuals cope with diabetic neuropathy?

Along with the healthy lifestyle changes recommended above, there are some measures you can take at home to help you manage your neuropathy.

Mayo Clinic reports that alpha-lipoic acid and acetyl-L-carnitine may help some people to manage neuropathy symptoms. The site also states that capsaicin cream can be topically applied for a reduction in neuropathy pain.

Another recommendation is to try using a transcutaneous electrical nerve stimulation (TENS) unit. This is a simple electrical device that sends impulses through electrodes to block pain signals in your nerves. 

A TENS unit is usually side effect-free, which can be advantage compared to some medications.

You might think that it would be expensive, but there are places you can buy a TENS unit for under $50, including on The biggest expense is actually the need to regularly replace the electrodes. It is a purchase well worth making, however, as it can provide you with relief throughout the day.

Is diabetic neuropathy reversible?

No, it is not possible to reverse diabetic neuropathy. But you can learn to manage the condition and improve your quality of life. Review the recommendations in this post, and talk with your doctor to develop a personalized treatment plan.

Posted by: Johannes Sauer

Johannes is the CEO and Co-Founder of Cadense and passionate about helping people with walking difficulties. Johannes is the CEO and Co-Founder of Cadense and passionate about helping people with walking difficulties. He was immediately drawn to the mission of the company because his cousin lost his lower leg in a tragic motorcycle accident a few years ago and is experiencing walking difficulties ever since. Johannes brings over a decade of experience in working for consumer product companies to Cadense. He holds an MBA from the University of Graz in Austria. Johannes lives with his family in Santa Barbara, CA.

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