What Is Diabetic Neuropathy? Symptoms, Causes and Foot Care Advice
Updated: Jul 8
If you have diabetes, you may have heard the term diabetic neuropathy, but what does it actually mean?
Diabetic neuropathy is a type of small vessel disease that can occur in people with diabetes. It most commonly affects the feet and legs and can lead to symptoms such as numbness, tingling, burning sensations or reduced feeling.
Not everyone with diabetes develops neuropathy (and not everyone with neuropathy has diabetes), and symptoms can vary considerably from person to person. However, understanding diabetic neuropathy is important because early recognition and appropriate foot care can help reduce the risk of complications.
In this guide, we'll explain what diabetic neuropathy is, why it happens, how it affects the feet and what you can do to protect your foot health.
What Is Diabetic Neuropathy?
Diabetic neuropathy is a condition where the nerves become damaged due to the effects of diabetes.
The word "neuropathy" simply means nerve disease or nerve damage.
There are several types of diabetic neuropathy, but the most common type affecting the feet is peripheral neuropathy, which affects the nerves in the:
Feet
Toes
Ankles
Lower legs
These nerves are responsible for:
Feeling touch
Detecting pain
Sensing temperature
Helping muscles function normally
When these nerves become damaged, they may stop working properly.
Why Does Diabetes Cause Neuropathy?
Over time, high blood glucose levels can damage both the nerves themselves and the small blood vessels that supply them.
This can affect how the nerves send and receive signals.
Several factors may increase the risk of developing diabetic neuropathy, including:
Having diabetes for a long time
Poor blood sugar control
High blood pressure
Smoking
Reduced circulation
Increasing age
However, not everyone with diabetes develops neuropathy.
What Are the Symptoms of Diabetic Neuropathy?
Symptoms can vary considerably.
Some people experience severe symptoms, while others notice very little.
Common symptoms include:
Numbness in the feet
Tingling or pins and needles
Burning sensations
Sharp or shooting pain
Reduced ability to feel temperature
Reduced ability to feel pain
Increased sensitivity to touch
A feeling of wearing socks when barefoot
Sponginess under the feet
Symptoms often develop gradually.
Many people notice symptoms in both feet.
Can You Have Diabetic Neuropathy Without Knowing?
Yes.
One of the challenges of diabetic neuropathy is that some people develop reduced sensation gradually and may not realise it is happening.
This is one reason why regular diabetic foot assessments are so important.
A healthcare professional may identify reduced sensation before you notice any symptoms yourself.
Why Is Diabetic Neuropathy Important for Foot Health?
The main concern with diabetic neuropathy is not always the symptoms themselves.
Reduced sensation means you may not notice:
Cuts
Blisters
Pressure areas
Burns
Foreign objects in shoes
Changes to the skin
This can increase the risk of complications if injuries are not detected and treated promptly.
What Does Diabetic Neuropathy Feel Like?
People describe diabetic neuropathy in different ways.
Common descriptions include:
"My feet feel numb."
"My feet burn at night."
"It feels like pins and needles."
"My feet feel swollen even though they aren't."
"I feel like I'm walking on cotton wool."
"It feels like I'm wearing socks when I'm barefoot."
Symptoms may be worse at night.
Does Diabetic Neuropathy Cause Pain?
Sometimes.
Although neuropathy often causes reduced feeling, some people experience painful diabetic neuropathy.
Symptoms may include:
Burning pain
Sharp stabbing sensations
Electric shock-like feelings
Increased sensitivity
Painful diabetic neuropathy can affect sleep and quality of life.
Can Diabetic Neuropathy Be Reversed?
This is a common question.
Unfortunately, established nerve damage cannot usually be completely reversed.
However, good diabetes management may help:
Slow progression
Prevent further damage
Improve symptoms in some cases
Reduce the risk of complications
Early detection is important.
How Is Diabetic Neuropathy Diagnosed?
In the UK, diabetic neuropathy is often identified during routine diabetic foot assessments.
These assessments may include:
Sensation Testing
A healthcare professional may use a monofilament or other instruments to assess sensation.
Circulation Assessment
Blood flow to the feet may also be assessed.
Examination of the Feet
The skin, nails and foot structure are usually examined.
How Can You Protect Your Feet If You Have Diabetic Neuropathy?
Good foot care habits are essential.
Check Your Feet Daily
Look for:
Cuts
Blisters
Redness
Swelling
Changes in skin colour
Cracks
Nail problems
Smells
Avoid Walking Barefoot
Reduced sensation means injuries may occur without you noticing.
Wear Well-Fitting Footwear
Shoes should be:
Comfortable
Supportive
Free from rubbing
Check Your Shoes
Before putting your shoes on, check for:
Stones
Loose objects
Damaged linings
Regular moisturising can help prevent cracks and dry skin.
Avoid applying cream between the toes.
When Should You Seek Medical Advice?
You should seek professional advice if you notice:
New numbness
Burning pain
Changes in sensation
Foot wounds
Redness
Swelling
Changes in skin colour
A wound that is not healing
Prompt assessment is important.
Final Thoughts
Diabetic neuropathy is a common complication of diabetes that can affect sensation, circulation and overall foot health.
While the condition can sound worrying, understanding the symptoms and taking simple steps to protect your feet can significantly reduce the risk of complications.
Regular foot checks, appropriate footwear and routine diabetic foot assessments remain some of the most important ways to maintain healthy feet when living with diabetes.
Comments