Diabetes-related neuropathy

Diabetes and your nerves

Diabetes-related neuropathy is a type of nerve damage that can affect people living with diabetes. It can affect the nerves that supply your: 

• feet and legs 
• arms and hands 
• organs, such as your heart, stomach, bowel and bladder. 

Nerve damage in your legs, feet, arms and hands is called ‘peripheral neuropathy’. Damage to these nerves can cause problems with: 

• sensation (how well you can feel touch, temperature and pain) 
• muscle movement, co-ordination and strength. 

Damage to the nerves that supply your internal organs is called ‘autonomic neuropathy’. These nerves carry signals from your brain to control things like your: 

• blood pressure 
• heart rate 
• digestion 
• sweating.  

Symptoms of diabetes-related neuropathy

Many people with diabetes-related neuropathy do not have any symptoms. Symptoms depend on which nerves are affected. 

Peripheral neuropathy  

You may have symptoms in your legs and feet (and sometimes arms and hands) such as: 

• pain that feels sharp, shooting, or like an electric shock 
• a burning feeling 
• numbness or lack of feeling 
• tingling or pins and needles 
• weakness 
• muscle cramps. 

Autonomic neuropathy 

Symptoms can differ depending on the organ(s) involved. They can include: 

• feeling light-headed, due to trouble keeping your blood pressure steady
• bloating and vomiting, due to slow stomach emptying 
• diarrhoea and constipation, due to bowel movement problems 

You may also have bladder or sexual health problems, such as: 

• trouble emptying your bladder (peeing) 
• peeing more or less often than usual 
• bladder leaks or loss of bladder control 
• trouble getting or keeping an erection in men
• vaginal dryness or trouble with arousal in women. 

Other symptoms may include: 

• not noticing the signs of low blood glucose (hypoglycaemia or hypos) 
• sweating more or less than usual 
• hearing loss 
• swelling of your ankles. 

Talk to your health professional if you have any of these symptoms.  

Lowering your risk of nerve damage

The longer you have been living with diabetes, the higher your risk or diabetes-related nerve damage.  

There are things you can do to lower your risk, including: 

• keeping your blood glucose levels in your target range as much as possible 
• keeping your blood pressure in the healthy range 
• keeping your cholesterol levels in the healthy range. 

Treatment for diabetes-related neuropathy

It’s important to keep working with your doctor or nurse practitioner to keep your glucose levels, blood pressure and cholesterol in a healthy range. This can slow down the symptoms of nerve damage if it develops. 

There are medicines you can take to treat: 

• nerve pain 
• some symptoms of autonomic neuropathy. 

Other treatments may include: 

• changes to your diet to help with symptoms of slow stomach emptying 
• other treatments to help you manage nerve pain 
• daily foot care. 

Your general practitioner (GP) may refer you to a specialist for tests and treatment. 

Diabetes health checks

People with diabetes should have checks for nerve problems at least once a year. This involves your health professional checking the sensation in your feet and legs. 

Having these health checks helps to pick up any problems early. 

Regular foot health checks

People living with diabetes are at risk of foot health problems. Having nerve damage and not feeling pain is one reason for this. That’s because pain helps you know when there is a problem. If you can’t feel pain, wounds and other problems can start to form without you knowing. In this case, you will need to take extra care. 

It’s very important to have your regular foot health checks when you have nerve damage in your legs and feet.  

When to see your health professional

See your health professional if you have any symptoms of nerve damage.  

You should keep seeing your health professional for day-to-day management of your diabetes, and for your regular health checks. 

It can be difficult living with ongoing nerve pain. Your doctor can provide mental health support. There are also support services available.