It's also a good idea to take a break from sitting every 30 minutes to get a few quick bursts of activity. Talk with your health care provider or physical therapist before you start exercising.

If you have decreased feeling in your legs, some types of exercise, such as walking, may be safer than others. If you have a foot injury or sore, stick with exercise that doesn't require putting weight on your injured foot. There are many alternative therapies that may help with pain relief on their own or in combination with medications.

But check with your health care provider before using any alternative therapy or dietary supplement to make sure that you don't have any potential interactions.

Living with diabetic neuropathy can sometimes be challenging. Support groups can offer encouragement and advice about living with diabetic neuropathy. Ask your health care provider if there are any in your area, or for a referral to a therapist.

The ADA offers online support through its website. If you find yourself feeling depressed, it may help to talk to a counselor or therapist. If you don't already see a specialist in treating metabolic disorders and diabetes endocrinologist , you'll likely be referred to one if you start showing signs of diabetes complications.

You may also be referred to a specialist in brain and nervous system problems neurologist. On this page. Self care. Alternative medicine. Coping and support. Preparing for your appointment. Your health care provider typically checks your: Overall muscle strength and tone Tendon reflexes Sensitivity to touch, pain, temperature and vibration Along with the physical exam, your health care provider may perform or order specific tests to help diagnose diabetic neuropathy, such as: Filament testing.

A soft nylon fiber monofilament is brushed over areas of your skin to test your sensitivity to touch. Sensory testing. This noninvasive test is used to tell how your nerves respond to vibration and changes in temperature.

Nerve conduction testing. This test measures how quickly the nerves in your arms and legs conduct electrical signals. Called needle testing, this test is often done along with nerve conduction studies.

It measures electrical discharges produced in your muscles. Autonomic testing. Special tests may be done to determine how your blood pressure changes while you are in different positions, and whether your sweating is within the standard range. More Information.

Electromyography EMG. Diabetic neuropathy has no known cure. The goals of treatment are to: Slow progression Relieve pain Manage complications and restore function. Slowing progression of the disease Consistently keeping your blood sugar within your target range is the key to preventing or delaying nerve damage.

Relieving pain Many prescription medications are available for diabetes-related nerve pain, but they don't work for everyone. Pain-relieving prescription treatments may include: Anti-seizure drugs. Some medications used to treat seizure disorders epilepsy are also used to ease nerve pain. The ADA recommends starting with pregabalin Lyrica.

Gabapentin Gralise, Neurontin also is an option. Side effects may include drowsiness, dizziness, and swelling in the hands and feet. Managing complications and restoring function To manage complications, you may need care from different specialists.

The treatment you'll need depends on the neuropathy-related complications you have: Urinary tract problems. Some drugs affect bladder function, so your health care provider may recommend stopping or changing medications. A strict urination schedule or urinating every few hours timed urination while applying gentle pressure to the bladder area below your bellybutton can help some bladder problems.

Other methods, including self-catheterization, may be needed to remove urine from a nerve-damaged bladder. Digestive problems. To relieve mild signs and symptoms of gastroparesis — indigestion, belching, nausea or vomiting — eating smaller, more frequent meals may help.

Diet changes and medications may help relieve gastroparesis, diarrhea, constipation and nausea. Sexual dysfunction. Medications taken by mouth or injection may improve sexual function in some men, but they aren't safe and effective for everyone.

Mechanical vacuum devices may increase blood flow to the penis. Women may benefit from vaginal lubricants. Request an appointment.

These measures can help you feel better overall and reduce your risk of diabetic neuropathy: Keep your blood pressure under control. If you have high blood pressure and diabetes, you have an even greater risk of complications.

Try to keep your blood pressure in the range your health care provider recommends, and be sure to have it checked at every office visit. Make healthy food choices. Eat a balanced diet that includes a variety of healthy foods — especially vegetables, fruits and whole grains.

Limit portion sizes to help achieve or maintain a healthy weight. Stop smoking. Using tobacco in any form makes you more likely to develop poor circulation in your feet, which can cause problems with healing.

If you use tobacco, talk to your health care provider about finding ways to quit. For diabetic neuropathy, you may want to try: Capsaicin. Capsaicin cream, applied to the skin, can reduce pain sensations in some people.

Side effects may include a burning feeling and skin irritation. Alpha-lipoic acid. This powerful antioxidant is found in some foods and may help relieve nerve pain symptoms in some people. This nutrient is naturally made in the body and is available as a supplement.

It may ease nerve pain in some people. Transcutaneous electrical nerve stimulation TENS. This prescription therapy may help prevent pain signals from reaching the brain.

transcutaneous electrical nerve stimulation TENS delivers tiny electrical impulses to specific nerve pathways through small electrodes placed on the skin. Although safe and painless, doesn't work for everyone or for all types of pain. Acupuncture may help relieve the pain of neuropathy, and generally doesn't have any side effects.

Keep in mind that you may not get immediate relief with acupuncture and might require more than one session. Diabetic neuropathy and dietary supplements.

To prepare for your appointment, you may want to: Be aware of any pre-appointment restrictions. When you make the appointment, ask if there's anything you need to do in advance, such as restrict your diet.

Make a list of any symptoms you're having, including any that may seem unrelated to the reason for the appointment. Make a list of key personal information, including any major stresses or recent life changes.

Make a list of all medications, vitamins, herbs and supplements you're taking and the doses. Bring a record of your recent blood sugar levels if you check them at home.

Ask a family member or friend to come with you. It can be difficult to remember everything your health care provider tells you during an appointment. Someone who accompanies you may remember something that you missed or forgot.

Make a list of questions to ask your health care provider. Some basic questions to ask may include: Is diabetic neuropathy the most likely cause of my symptoms? Do I need tests to confirm the cause of my symptoms? How do I prepare for these tests?

Is this condition temporary or long lasting? If I manage my blood sugar, will these symptoms improve or go away? Are there treatments available, and which do you recommend? What types of side effects can I expect from treatment? I have other health conditions. How can I best manage them together?

Are there brochures or other printed material I can take with me? What websites do you recommend? Do I need to see a certified diabetes care and education specialist, a registered dietitian, or other specialists? What to expect from your doctor Your health care provider is likely to ask you a number of questions, such as: How effective is your diabetes management?

When did you start having symptoms? Do you always have symptoms or do they come and go? How severe are your symptoms? Does anything seem to improve your symptoms?

You may not notice anything is wrong until considerable nerve damage has occurred. This type of neuropathy may also be called distal symmetric peripheral neuropathy. It's the most common type of diabetic neuropathy. It affects the feet and legs first, followed by the hands and arms.

Signs and symptoms of peripheral neuropathy are often worse at night, and may include:. The autonomic nervous system controls blood pressure, heart rate, sweating, eyes, bladder, digestive system and sex organs.

Diabetes can affect nerves in any of these areas, possibly causing signs and symptoms including:. This type of neuropathy often affects nerves in the thighs, hips, buttocks or legs.

It can also affect the abdominal and chest area. Symptoms are usually on one side of the body, but may spread to the other side. Proximal neuropathy may include:.

Mononeuropathy refers to damage to a single, specific nerve. The nerve may be in the face, torso, arm or leg. Mononeuropathy may lead to:. The American Diabetes Association ADA recommends that screening for diabetic neuropathy begin immediately after someone is diagnosed with type 2 diabetes or five years after diagnosis with type 1 diabetes.

After that, screening is recommended once a year. The exact cause of each type of neuropathy is unknown. Researchers think that over time, uncontrolled high blood sugar damages nerves and interferes with their ability to send signals, leading to diabetic neuropathy.

High blood sugar also weakens the walls of the small blood vessels capillaries that supply the nerves with oxygen and nutrients. Anyone who has diabetes can develop neuropathy. But these risk factors make nerve damage more likely:. You can prevent or delay diabetic neuropathy and its complications by closely managing your blood sugar and taking good care of your feet.

The American Diabetes Association ADA recommends that people living with diabetes have a glycated hemoglobin A1C test at least twice a year. This test indicates your average blood sugar level for the past 2 to 3 months.

glycated hemoglobin A1C goals may need to be individualized, but for many adults, the ADA recommends an A1C of less than 7. If your blood sugar levels are higher than your goal, you may need changes in your daily management, such as adding or adjusting your medications or changing your diet or physical activity.

Foot problems, including sores that don't heal, ulcers and even amputation, are common complications of diabetic neuropathy. But you can prevent many of these problems by having a thorough foot exam at least once a year. Also have your health care provider check your feet at each office visit and take good care of your feet at home.

Follow your health care provider's recommendations for good foot care. To protect the health of your feet:.

On this page. When to see a doctor. Risk factors. A Book: The Essential Diabetes Book. Peripheral neuropathy This type of neuropathy may also be called distal symmetric peripheral neuropathy. Signs and symptoms of peripheral neuropathy are often worse at night, and may include: Numbness or reduced ability to feel pain or temperature changes Tingling or burning feeling Sharp pains or cramps Muscle weakness Extreme sensitivity to touch — for some people, even a bedsheet's weight can be painful Serious foot problems, such as ulcers, infections, and bone and joint damage.

Autonomic neuropathy The autonomic nervous system controls blood pressure, heart rate, sweating, eyes, bladder, digestive system and sex organs. Diabetes can affect nerves in any of these areas, possibly causing signs and symptoms including: A lack of awareness that blood sugar levels are low hypoglycemia unawareness Drops in blood pressure when rising from sitting or lying down that may cause dizziness or fainting orthostatic hypotension Bladder or bowel problems Slow stomach emptying gastroparesis , causing nausea, vomiting, sensation of fullness and loss of appetite Difficulty swallowing Changes in the way the eyes adjust from light to dark or far to near Increased or decreased sweating Problems with sexual response, such as vaginal dryness in women and erectile dysfunction in men.

Proximal neuropathy diabetic polyradiculopathy This type of neuropathy often affects nerves in the thighs, hips, buttocks or legs. Proximal neuropathy may include: Severe pain in the buttock, hip or thigh Weak and shrinking thigh muscles Difficulty rising from a sitting position Chest or abdominal wall pain.

Mononeuropathy focal neuropathy Mononeuropathy refers to damage to a single, specific nerve. Mononeuropathy may lead to: Difficulty focusing or double vision Paralysis on one side of the face Numbness or tingling in the hand or fingers Weakness in the hand that may result in dropping things Pain in the shin or foot Weakness causing difficulty lifting the front part of the foot foot drop Pain in the front of the thigh.

More Information. Types of diabetic neuropathy. Call your health care provider for an appointment if you have: A cut or sore on your foot that is infected or won't heal Burning, tingling, weakness or pain in your hands or feet that interferes with daily activities or sleep Changes in digestion, urination or sexual function Dizziness and fainting The American Diabetes Association ADA recommends that screening for diabetic neuropathy begin immediately after someone is diagnosed with type 2 diabetes or five years after diagnosis with type 1 diabetes.

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You may opt-out of email communications at any time by clicking on the unsubscribe link in the e-mail. But these risk factors make nerve damage more likely: Poor blood sugar control. Uncontrolled blood sugar increases the risk of every diabetes complication, including nerve damage. Diabetes history.

The risk of diabetic neuropathy increases the longer a person has diabetes, especially if blood sugar isn't well controlled.

Kidney disease. Diabetes can damage the kidneys. Kidney damage sends toxins into the blood, which can lead to nerve damage. Being overweight. Having a body mass index BMI of 25 or more may increase the risk of diabetic neuropathy.

Smoking narrows and hardens the arteries, reducing blood flow to the legs and feet. This makes it more difficult for wounds to heal and damages the peripheral nerves. Diabetic neuropathy can cause a number of serious complications, including: Hypoglycemia unawareness.

But people who have autonomic neuropathy may not experience these warning signs. Loss of a toe, foot or leg. Nerve damage can cause a loss of feeling in the feet, so even minor cuts can turn into sores or ulcers without being noticed. In severe cases, an infection can spread to the bone or lead to tissue death.

Removal amputation of a toe, foot or even part of the leg may be necessary. Urinary tract infections and urinary incontinence.

If the nerves that control the bladder are damaged, the bladder may not empty completely when urinating. Bacteria can build up in the bladder and kidneys, causing urinary tract infections.

Nerve damage can also affect the ability to feel the need to urinate or to control the muscles that release urine, leading to leakage incontinence. Sharp drops in blood pressure. Damage to the nerves that control blood flow can affect the body's ability to adjust blood pressure. This can cause a sharp drop in pressure when standing after sitting or lying down, which may lead to lightheadedness and fainting.

Digestive problems. If nerve damage occurs in the digestive tract, constipation or diarrhea, or both are possible. Diabetes-related nerve damage can lead to gastroparesis, a condition in which the stomach empties too slowly or not at all.

This can cause bloating and indigestion. Sexual dysfunction. Autonomic neuropathy often damages the nerves that affect the sex organs. Men may experience erectile dysfunction. Women may have difficulty with lubrication and arousal. Increased or decreased sweating.

Nerve damage can disrupt how the sweat glands work and make it difficult for the body to control its temperature properly. Blood sugar management The American Diabetes Association ADA recommends that people living with diabetes have a glycated hemoglobin A1C test at least twice a year.

Foot care Foot problems, including sores that don't heal, ulcers and even amputation, are common complications of diabetic neuropathy. To protect the health of your feet: Check your feet every day. Look for blisters, cuts, bruises, cracked and peeling skin, redness, and swelling. Use a mirror or ask a friend or family member to help examine parts of your feet that are hard to see.

Proximal neuropathy is a rare and disabling type of nerve damage in your hip, buttock, or thigh. The damage typically affects one side of your body and may rarely spread to the other side. Symptoms gradually improve over a period of months or years.

The NIDDK and other components of the National Institutes of Health NIH support and conduct research into many diseases and conditions. View clinical trials that are currently recruiting volunteers. See more about diabetes research at the NIDDK. This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases NIDDK , part of the National Institutes of Health.

NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public.

Content produced by NIDDK is carefully reviewed by NIDDK scientists and other experts. The NIDDK would like to thank: Rodica Pop-Busui, M. Home Health Information Diabetes Diabetes Overview Preventing Diabetes Problems Diabetic Neuropathy. To do this, be consistent in:.

If you do develop diabetic neuropathy, work closely with a doctor and follow their recommendations for slowing its progression. With proper care, you can reduce the damage to your nerves and avoid complications.

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Medically reviewed by Kelly Wood, MD — By Carmella Wint, Matthew Solan, and Brian Wu — Updated on November 22, Symptoms Types Causes Diagnosis Treatment Prevention Diabetic neuropathy is a type of nerve damage that develops gradually and is caused by long-term high blood sugar levels.

What are the symptoms of diabetic neuropathy? What are the different types of diabetic neuropathy? Explore our top resources.

What causes diabetic neuropathy? Discover more about Type 2 Diabetes. How is diabetic neuropathy diagnosed? How is diabetic neuropathy treated?

Can I prevent diabetic neuropathy? How we reviewed this article: Sources. Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations.

We avoid using tertiary references. You can learn more about how we ensure our content is accurate and current by reading our editorial policy. Nov 22, Edited By Rachael Ajmera, MS, RD.

Share this article. Read this next. Diabetic Neuropathy: Can It Be Reversed? The restriction of blood flow to the damaged nerves leads to the chronic, debilitating pain. Nerve pain can make doing the simplest things very painful. Diabetes develops in children and adults typically as a result of the body not producing enough insulin.

What is insulin? The purpose of insulin is to help cells use glucose or sugar found in food to produce energy.

Now, if there is too much sugar in the blood, this can lead to complications, such as diabetes. Often times affecting the kidneys, heart, nerves and eyes.