Diabetic neuropathy is nerve damage that can develop as a result of diabetes. Burning, tingling, pain, or reduced sensation may occur, particularly in the feet. Widespread nerve damage and compression of a nerve at a specific point are different from one another; they can also be present together in the same person.
How does diabetes affect the nerves?
Diabetes-related peripheral neuropathy is most commonly seen in the feet and legs; the hands can also be affected. Unlike compression of a nerve at a single point, this is a more widespread form of damage. A person with diabetes may also have localised nerve compression, but these are not the same diagnosis.
Pain and loss of sensation should be assessed together
- Burning, stinging, or tingling in the feet.
- Reduced sensation of touch, temperature, or pain.
- Balance problems and unnoticed pressure points or wounds.
Mild pain does not mean the damage is minor. Reduced sensation can mean that a shoe rubbing or a small wound goes unnoticed.
What is assessed during examination?
The skin of the foot, sensation, muscle strength, reflexes, and circulation are assessed together. Diabetes control, medications, and any accompanying conditions are reviewed. If necessary, other causes of neuropathy such as vitamin deficiency, or compression on a specific nerve, are investigated.
Treatment and foot protection
Blood sugar management, foot care, and pain treatment are addressed together. Regular visual checks of the feet, wearing suitable footwear, and early detection of wounds are important. A healthcare provider should be consulted if there is a new wound, redness, swelling, or discharge.
The place of nerve decompression surgery
Generalised diabetic neuropathy does not, on its own, require nerve decompression surgery. If an accompanying localised compression such as carpal tunnel or tarsal tunnel is suspected, it is assessed separately. The decision for surgery takes into account the condition of the nerve, circulation, and factors affecting wound healing.
Frequently Asked Questions
No. Other nerve, circulation, or skin problems can cause similar symptoms; an assessment is needed.
No such generalisation can be made. Widespread diabetes-related nerve damage and an additional localised compression are assessed separately.
Sources and information
This content is for general information only; it does not replace personal diagnosis, treatment advice or a medical consultation. The applicability of recommendations in these sources depends on your individual situation and local practice.