Diabetic Neuropathy and Nerve Damage

Diabetic neuropathy may develop at any time in your life. Early diagnosis and treatment can help prevent further complications and nerve damage.

Our foot and ankle surgeons at the Orthopedic Foot & Ankle Center are expertly trained in all forms of diabetic foot care. You can call us or make an appointment online. We have convenient locations throughout Greater Columbus, Ohio.

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What is Diabetic Neuropathy and Nerve Damage?

Neuropathy is a condition that can develop from diabetes. Neuropathy is a term used to define nerve damage. Diabetes can cause damage to the peripheral nerves that provide sensation and control movement. This is sometimes referred to as peripheral neuropathy.

When you have diabetes, it’s possible to develop nerve problems at any time. Sometimes nerve damage can be the first sign of diabetes. You may develop significant nerve problems within 10 years after being diagnosed with diabetes. The longer you have diabetes, the higher the risk of developing neuropathy. Neuropathy is present in about half of the people who have diabetes.

Types and Symptoms of Diabetic Neuropathy

There are a few different types of diabetic neuropathy. Each type has various symptoms according to how many nerves are affected and where the affected nerves are.

A woman with foot nerve damage in Columbus, OH.

Focal Neuropathy (Diabetic Mononeuropathy)

Focal neuropathy affects one nerve at a time. The symptoms will appear in the area of the affected nerve.

Some of the symptoms of focal neuropathy include the following:

  • Thigh pain
  • Severe pain in your lower back or pelvis
  • Pain in your chest, stomach, or flank
  • Inability to focus your eyes
  • Aching behind your eyes
  • Paralysis on one side of your face
  • Double vision
  • Hearing problems

Diabetic Polyneuropathy (DPN)

This type of diabetic neuropathy is when more than one of the peripheral sensory and motor nerves are affected. It could cause symptoms in any of the nerves that extend from your spinal cord, including your arms or hands. However, the most common nerves to be affected are those that extend from your spine to your feet.

DPN can cause the following symptoms:

  • Tingling, burning, or prickling sensations
  • Pain and numbness in the hands, legs and feet
  • Muscle weakness in the feet and hands
  • Sharp pains or cramps
  • Insensitivity to pain or temperature changes
  • Extreme sensitivity to touch
  • Loss of balance or coordination and difficulty walking on uneven surfaces


The loss of sensation in the extremities can lead to the following problems:

  • Development of wounds, ulcers, and chronic infections
  • Amputation
  • Vision
  • Problems with the digestive tract
  • Erectile dysfunction


DPN can also be divided into two distinct types – diabetic autonomic neuropathy and proximal neuropathy.

Diabetic Autonomic Neuropathy

This type of DPN affects the autonomic nerves that are found in your internal organs. This type of neuropathy can affect the nerves of your digestive system, urinary tract or sexual organs, and sweat glands.

Symptoms of diabetic autonomic neuropathy include the following:

  • Continuous nausea and vomiting
  • Constipation or diarrhea
  • Sweating extremes
  • Digestive problems
  • Sexual dysfunction
  • Impaired perception of pain
  • Low blood pressure
  • Hypoglycemia

Proximal Neuropathy (Diabetic Amyotrophy)

Proximal neuropathy affects about 1% of those who have type 2 diabetes. It is more common among older adults.

The main symptom of proximal neuropathy is nerve pain in the upper thigh. It can also be felt in the hip and lower back. Other symptoms include the following:

  • Weight loss
  • Weakness in the affected area
  • Spreading of pain into the lower legs over time
  • In rare cases, pain in the arm
  • Foot drop


A proper diagnosis is essential as this type of diabetic neuropathy has similar symptoms to many other conditions.

Causes of Diabetic Neuropathy

A foot doctor treating diabetic neuropathy in Columbus, Ohio.

There seem to be several factors that may contribute towards diabetic neuropathy. The following list highlights some of the causes.

  • Damage or malfunction of the body’s insulin system: This can cause high levels of sugar in the blood, which can damage nerves in the body and lead to diabetic neuropathy.
  • Presence of autoimmune diseases: These diseases cause the body to attack its own tissues and nerves, leading to nerve damage.
  • Poor circulation caused by narrowing of blood vessels: This reduces oxygen supply to nerves and increases inflammation, contributing to damage of the nerves and the development of diabetic neuropathy.
  • Vitamin deficiencies: Certain vitamins like vitamin B-12 play an important role in maintaining proper nerve function, and a deficiency can contribute to developing diabetic neuropathy.
  • Genetics: Certain genetic factors may make some people more likely to develop diabetic neuropathy, even when all other causes are absent.

How is Diabetic Neuropathy Diagnosed?

If you suspect diabetic neuropathy, you should seek out an early diagnosis. Treatment will help prevent further damage.

Your doctor will likely use a variety of diagnosis methods, including the following:

  • Consult your medical history: Previous conditions will be taken into consideration
  • Physical examination: Your doctor will check strength, reflexes, and sensitivity
  • Electromyography: To see how muscles respond to electrical impulses
  • Nerve conduction studies: To measure the electrical current through a nerve
  • Skin biopsies: To assess cutaneous nerve intervention
  • Nerve and muscle biopsies: For a histopathological evaluation


You may also require the following tests to rule out any other causes of your symptoms:

  • Blood pressure test
  • Blood glucose screening
  • Cholesterol test

Treatment for Diabetic Neuropathy

Treating diabetic neuropathies involves two strategies. First, your doctor will try controlling diabetes with lifestyle changes and sometimes medications. Secondly, your doctor will manage pain and treat any other conditions. The following outlines some of these treatment strategies:

Lifestyle Changes

Lifestyle factors can help to reduce blood sugar levels and control other risk factors. This could include trying the following:

  • Reduce blood glucose levels: You will be given specific blood sugar goals to reach throughout the day. Eating a diet high in protein and low in carbs will help.
  • Regular exercise: Exercise helps increase insulin sensitivity.
  • Getting sufficient rest
  • Treating high blood pressure
  • Treating high cholesterol
  • Weight loss (if obese)

Managing Pain and Other Complications

As mentioned before, diabetes neuropathy can cause chronic pain and other complications such as urinary or sexual problems, gastrointestinal problems, dizziness, and weakness. Treatments for these symptoms include the following:

  • Pain medications
  • Antidepressants
  • Anti-seizure medications
  • Transcutaneous electronic nerve stimulation (TENS) therapy
  • Topical creams
  • Relaxation training
  • Hypnosis
  • Acupuncture
  • Biofeedback training


Your doctor will select the best treatment for your symptoms according to the severity of your condition.

Is Diabetic Neuropathy Reversible?

Unfortunately, nerve damage cannot be reversed. The best course of action is treatment to prevent diabetic neuropathy from getting worse. High blood sugar levels can damage the nerves, so reducing them can help prevent further damage.

Get Treatment Now

Our foot and ankle surgeons at the Orthopedic Foot & Ankle Center are expertly trained in all forms of treatments, including diabetic foot care. Call us today or make an appointment online. We have convenient locations throughout Greater Columbus, OH.

Medically reviewed by Terrence M. Philbin, DO

Our Diabetic Foot Care Specialist​s​

JUSTIN R. HUDSON, DPM

Board Certified Podiatric Surgeon and Wound Specialist

LYNETTE R. MEHL, DPM

Board Certified Podiatric Physician, Clinical Podiatrist

SARAH ABSHIER, DPM, CWS

Clinical Podiatrist, Certified Wound Specialist

ROBERTO A. BRANDÃO, DPM

Board Certified, Fellowship Trained Foot & Ankle Surgeon
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