What is diabetic neuropathy?

Diabetic neuropathy is a type of nerve damage that can affect people with diabetes. It can affect:

• sensory nerves — which let you feel pain, touch and temperature
• motor nerves — which carry signals for you to move your muscles
• autonomic nerves

Autonomic nerves carry signals to help with many of the things you do without thinking, such as:

• sweating
• digestion
• blood pressure and heart rate control

Diabetic neuropathy most often affects the sensory and motor nerves in your legs and feet. This is known as peripheral neuropathy.

What are the symptoms of diabetic neuropathy?

Up to 1 in 2 people with diabetic neuropathy do not have symptoms.

Symptoms of diabetic peripheral neuropathy are unusual feelings in your legs and arms such as:

• pain and discomfort, especially at night
• burning
• tingling
• numbness
• weakness

Symptoms often begin in your feet or hands. These symptoms may later spread to your legs and arms.

Symptoms of diabetic neuropathy that affect your autonomic nerves (autonomic neuropathy) can include:

• bloating, heartburn and indigestion
• heat intolerance and problems with sweating
• diarrhoea or constipation
• problems with urinating (doing a wee)
• low blood pressure on standing, which can cause lightheadedness
• problems with sexual function, including erectile dysfunction
• not being able to recognise when your blood sugar is low (hypoglycaemia)

Autonomic neuropathy can also cause problems with controlling your heart rate.

What causes diabetic neuropathy?

Having high levels of sugar in your blood over a long time increase the chance of damage to your nerves.

Other factors that can increase your risk of diabetic neuropathy are:

• high blood pressure
• high levels of triglycerides, a type of fat found in the blood
• being overweight
• smoking

The longer you have had diabetes, the more likely you are to develop diabetic neuropathy.

When should I see my doctor?

See your doctor if you have diabetes and any symptoms of nerve damage, such as numbness or tingling in your hands or feet. Also see your doctor if you have a sore on your foot that won’t heal.

If you have diabetes, you should have regular check-ups with your doctor. This is to check your blood glucose control and look for any complications of diabetes.

How is diabetic neuropathy diagnosed?

Your doctor will ask you about your symptoms and your blood sugar control. They will examine you and may recommend that you have some tests, such as blood tests.

Your doctor might refer you to a specialist doctor for further tests and treatment.

Your doctor may also refer you to other health professionals, such as a:

• podiatrist
• diabetes educator
• dietitian

How is diabetic neuropathy treated?

Specific treatment will depend on the nerves that are affected.

You can help stop your symptoms getting worse by working with your doctor and healthcare team to control your blood sugar levels.

Your doctor may also recommend treatments to control your blood pressure and cholesterol.

Peripheral neuropathy

Treatment for peripheral neuropathy may include:

• pain-relief medicines and other medicines to reduce your pain
• other treatments for pain, such as TENS
• foot care, including treatment with a podiatrist

Talk to your doctor about what treatments may work best for you.

Autonomic neuropathy

Treatment for autonomic neuropathy will depend on your symptoms. Possible options include self-care measures and medicines to relieve your symptoms.

Talk to your doctor about the treatments that may help with your autonomic nerve damage.

What are the complications of diabetic neuropathy?

Complications will depend on the nerves affected.

Peripheral neuropathy can lead to foot:

• wounds
• injuries
• ulcers
• infections

Diabetic autonomic neuropathy can increase your risk of having a heart attack.

Your risk of depression may also be increased if you have diabetic neuropathy.

Can diabetic neuropathy be prevented?

The most important thing you can do to prevent diabetic neuropathy is to work with your medical team to:

• control your blood sugar levels
• keep your blood pressure in a healthy range
• keep your cholesterol levels in a healthy range

A healthy lifestyle can help with this. This means:

• eating a balanced healthy diet
• being active every day
• not smoking or vaping
• limiting the amount of alcohol you drink

Resources and support

Read more about diabetes on the Diabetes Australia website. Diabetes Australia has resources for Aboriginal and/or Torres Strait Islander people.

The National Diabetes Services Scheme has information on diabetes, including information in languages other than English.

Everyone with diabetes has to be careful about their feet — read more on the Diabetes Australia website.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with you 24 hours a day, 7 days a week.