Diabetic neuropathy is a complication of diabetes that damages the nervous system. Depending on the type, a person may feel a burning or itching sensation, numbness, or extreme sensitivity to touch or temperature.

Diabetic neuropathy is the name experts give to nerve damage that arises as a complication of diabetes. It is a progressive condition, meaning that symptoms will worsen over time.

There are four main types of diabetic neuropathy:

  • peripheral
  • autonomic
  • focal
  • proximal

Depending on the type of diabetic neuropathy they have, a person will experience its effects and physical sensations differently.

In this article, we will explore what diabetic neuropathy feels like, the symptoms and warning signs of diabetic neuropathy, and its causes, treatment options, and prevention.

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There are several distinct sensations people may feel as a result of diabetic neuropathy.


One very common symptom of diabetic neuropathy is numbness.

At times, a person may not feel their feet as they walk. Alternately, their hands may not register the sense of touch when they pick something up, as if they are wearing gloves, though they are not.

A person may also lose some or all of their ability to distinguish temperature or pain, meaning they may not notice cold, heat, or even injuries.

Sharp, burning pain

People with diabetic neuropathy may sometimes experience a sharp, sudden, shooting pain that feels as though a current is running through them.

These sensations can be surprising and may cause a person to drop things they are holding when this sharp pain occurs.

It is common for people to experience burning or shooting pains in the lower legs.


Tingling, or the “pins and needles” sensation, is another common sign of diabetic neuropathy. The medical term for pins and needles is paresthesia, and it often affects people worse at nighttime.


Diabetic peripheral neuropathy can also result in exaggerated sensitivity. Some people may experience distinct pain and sensitivity arising from diabetic neuropathy. This can be difficult and extremely unpleasant for some people, who may feel that the weight of a towel or blanket on top of them causes pain if their symptoms are especially bad.

Holding a cup of warm coffee may feel painfully hot. It may also hurt when someone with cold hands touches an individual with neuropathy.

According to a 2019 article, experts believe that this is due to the hyperexcitability of sensory neurons.

Other signs of diabetic neuropathy that people may experience include:

  • a loss of muscle tone in the hands and feet
  • issues with balance
  • difficulty sleeping, which may be due to pain and other symptoms
  • infected cuts or ulcers in the feet, due to a person not noticing cuts or blisters when their feet are numb
  • Charcot foot, a condition in which a joint breaks down due to nerve issues
  • dysesthesia, a distorted sense of touch that can feel like burning or itching
  • muscles feeling weak
  • muscular contractions
  • heartburn
  • bloating
  • gastric symptoms, such as constipation, diarrhea, or nausea
  • hypoglycemic unawareness, when someone does not feel the effects of low blood sugar
  • difficulty swallowing or speaking
  • orthostatic hypotension, feeling dizzy or lightheaded upon standing
  • heavy sweating, even if the person is not hot
  • bladder problems, such as not being able to empty the bladder fully when peeing

High levels of blood glucose and high levels of fats, such as triglycerides, in the bloodstream — both of which are typical in people with diabetes — can cause nerve damage over time.

Elevated blood sugar can also cause damage to a person’s small blood vessels. These blood vessels deliver oxygen and other nutrients to the nerves, without which, the nerves cannot function optimally.

The best treatment plan for diabetic neuropathy will depend on the specific subtype a person has.

There are four primary categories of neuropathy, each of which can affect a person’s nervous system in a different way.

  • Autonomic neuropathy: This type affects the nerves controlling involuntary bodily functions, such as digestion, heart rate, and the production of sweat and tears.
  • Mononeuropathies: These affect singular nerves.
  • Peripheral symmetric neuropathy: The most common form of diabetic neuropathy, this affects the extremities — the feet, hands, fingers, and toes.
  • Proximal neuropathy: This damages nerves along a specific distribution in the body, such as the hip or legs, and typically affects one side of the body.

Diabetic neuropathy worsens over time, regardless of type, and it is not possible to repair nerve damage. However, some medications and forms of physical therapy can help reduce pain and relieve other symptoms.


Medications that doctors prescribe to help manage the pain of diabetic neuropathy include:

  • anticonvulsant drugs
  • opioids and non-opioid pain relief medications
  • antidepressants

Opioid use may lead to dependency or an opioid use disorder, so health professionals should prescribe as low a dose as possible for pain management.

A person with diabetic neuropathy might use other types of antidepressants, such as serotonin-norepinephrine reuptake inhibitors (SNRIs), to treat other diabetic neuropathy symptoms that cause pain.

The best way for a person to prevent diabetic neuropathy is to focus on the underlying cause and avoid hyperglycemia. People should take care to:

  • manage their blood glucose levels and levels of fats in the blood and try to keep them within the range agreed upon with a doctor
  • exercise, have a balanced dietary plan, and correct any vitamin deficiencies in order to maintain nerve health
  • avoid smoking and drinking alcohol, or drink in moderation

Diabetic neuropathy occurs as a complication of diabetes and becomes gradually worse over time. It may feel like tingling, burning, numbness, shooting pains, or extreme sensitivity to heat and touch.

There is currently no cure for diabetes or for diabetic neuropathy. However, people can prevent diabetic neuropathy by carefully managing their blood sugar and blood fat levels.

People can treat the symptoms of diabetic neuropathy with medications, such as anticonvulsants and SNRIs, and physical therapy.