Diabetic neuropathy occurs when often high blood sugar damages the blood vessels feeding the nerves. This damage prevents the nerves from functioning properly and slows or even stops the transmission of messages between the brain and the affected area of the body.

There are two types of diabetic neuropathy:

  • Peripheral neuropathy: particularl affects the nerves of the legs and feet.
  • Autonomic neuropathy: affects the nerves of specific organs, such as the heart, genital o

Risk factors

  • Having high blood sugar often
  • Having a high level of triglycerides (fat) in the blood
  • Having high blood pressure
  • Having excess body weight
  • Smoking.


  • Loss of the ability to feel pain, heat and cold
  • Shooting pain, throbbing, prickling, tingling, numbness
  • The sensation of walking on cotton wool
  • Burning or stinging sensation, heightened during the night
  • Muscle weakness, cramps, spasms

Why take action?

The main danger of nerve damage with loss of feeling is injury to your feet without realizing it. When you have poor blood circulation, a wound can become infected and, if neglected or not treated properly, can lead to gangrene and amputation.


Your doctor, a podiatrist or a footcare nurse can do the following tests:

Sensitivity test using a monofilament
Vibration perception test using a tuning fork
Electromyography (EMG) can also be used
by a doctor to confirm the diagnosis


No. Instead, suggested treatments attempt to relieve the symptoms. Certain medications may be prescribed, and some topical skincare products are available over the counter.

Symptoms of Autonomic neuropathy

  • Accelerated heartrate
  • Sudden drop in blood pressure when standing from a seated or lying position
  • Inability to recognize the symptoms of low blood sugar (hypoglycemia)
  • Constipation or diarrhea
  • Gastroparesis: a slowing in digestion in the stomach leading to bloating, heartburn and even a blood sugar imbalance
  • Hyperactive bladder: an increase in urinary frequency and urgency and in urinary incontinence
  • Neurogenic bladder: a loss of sensation of a full bladder or a bladder that does not empty completely on urination
  • Sexual dysfunction: erectile dysfunction in men, difficulty becoming aroused and pain during sex in women


The main preventative measure is to maintain blood sugar within target levels. In addition, it is important to adopt healthy lifestyle habits, such as:

  • Doing regular exercice
  • Adopting a healthy and balanced diet
  • Managing weight, if applicable
  • Reducing alcohol consumption, if applicable
  • Quitting smoking or vaping, if applicable

Helpful resources

Research and writing: Diabetes Québec’s Team of health professionals

Septembre 2020