Peripheral Neuropathy in Diabetes: What It Is and How to Protect Your Nerves

Peripheral neuropathy is one of the most common complications of diabetes, affecting nearly half of all people with long-standing blood sugar issues. It develops gradually, often beginning with subtle numbness or tingling in the feet, and can progress to significant pain, balance problems, and mobility challenges. The good news is that early diagnosis and proactive treatment can slow its progression and protect nerve health.

Below, we break down what diabetic peripheral neuropathy is, why it develops, and the steps you can take to manage symptoms and maintain quality of life.

What Is Peripheral Neuropathy?

Peripheral neuropathy refers to nerve damage in the peripheral nervous system, typically affecting the feet and hands first. In people with diabetes, chronically elevated blood sugar levels can damage the small nerves responsible for sensation and movement, as well as the blood vessels that supply them.

Although neuropathy is most common in those with poorly controlled blood sugar, it can also occur despite good diabetes management due to genetic factors, lifestyle habits, or long-term inflammation.

Why Diabetes Causes Nerve Damage

Several factors contribute to nerve injury in diabetes:

• High blood sugar harms delicate nerve fibers and interferes with their ability to transmit signals.
• Reduced blood flow from damaged small blood vessels deprives nerves of oxygen and nutrients.
• Chronic inflammation increases stress on the nervous system.
• Metabolic changes related to insulin resistance affect how nerves function and repair themselves.

Together, these processes gradually impair nerve health and lead to the symptoms commonly associated with neuropathy.

Common Symptoms of Diabetic Peripheral Neuropathy

Symptoms often begin subtly and progress over time. They may include:

• Numbness or reduced sensation in the feet or hands
• Tingling, burning, or “pins and needles” sensations
• Sharp, electric, or shooting pain
• Sensitivity to touch, even light pressure
• Muscle weakness or difficulty walking
• Loss of balance or coordination
• Foot deformities or unnoticed injuries due to reduced sensation

Because neuropathy can impair the ability to feel cuts or injuries, it increases the risk of infections and ulcers, making routine foot checks especially important.

How Peripheral Neuropathy Is Diagnosed

A pain management specialist or neurologist may use:

• A physical and neurological exam
• Sensory testing
• Nerve conduction studies
• Blood tests to rule out other causes of nerve damage

Diagnosing neuropathy early allows for more effective symptom control and slows disease progression.

Treatment Options for Diabetic Peripheral Neuropathy

Although nerve damage is not always reversible, many therapies can significantly improve symptoms and protect remaining nerve function.

1. Medical Treatments

• Medications for nerve pain such as gabapentin, pregabalin, or duloxetine
• Topical treatments like lidocaine patches or capsaicin cream
• Alpha-lipoic acid or other antioxidant supplements, when clinically appropriate

2. Interventional Pain Management

• Nerve blocks for targeted relief
• Spinal cord stimulation for chronic, severe neuropathic pain
• Peripheral nerve stimulation to calm painful nerve signaling

3. Lifestyle and Preventive Care

• Tight blood sugar control
• Regular exercise to improve circulation
• Anti-inflammatory nutrition
• Daily foot inspections and proper footwear

When to See a Pain Specialist

You should seek evaluation if you notice persistent numbness, tingling, or burning sensations, especially in your feet. Early treatment helps protect nerve function and reduces the risk of long-term complications.

A pain specialist can assess your symptoms, rule out other nerve-related conditions, and build a personalized treatment plan that supports better comfort and quality of life.

Protecting Your Nerve Health

Although diabetic peripheral neuropathy is common, it does not have to limit your daily activities or independence. With early diagnosis, consistent blood sugar control, and advanced nerve-focused therapies, you can manage symptoms and maintain nerve health for the long term.

If you are experiencing signs of neuropathy, reach out to a pain specialist to explore your treatment options.