Diabetic Peripheral Neuropathy: Causes, Symptoms, and Treatment
Medically reviewed by Achuta Uppu, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Diabetic Peripheral Neuropathy?
An endocrinologist (a hormone and diabetes doctor) or a neurologist (a nerve doctor) often treats diabetic peripheral neuropathy. A podiatrist (a foot doctor) may help care for your feet. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is diabetic peripheral neuropathy?
Diabetic peripheral neuropathy is a type of nerve damage that typically affects the feet and legs. It sometimes affects the hands and arms. It is the most common type of nerve damage in people with diabetes, and it usually starts in the feet.
This type is very common. Up to one-half of people with diabetes have it.
Symptoms
Symptoms often start in the toes and feet and develop slowly over many years. Over time, nerve damage can reach the fingers and hands. Your feet, legs, hands, or arms may feel:
- burning
- tingling, like pins and needles
- numb
- painful
- weak
You may feel extreme pain, even when something touches you lightly. You may also have trouble sensing pain or temperature. Symptoms are often worse at night. Most of the time they affect both sides of the body, but they can affect only one side.
As damage gets worse, you may lose feeling in your feet and legs. You may then not notice a blister, a small cut, or something sharp under your foot.
Losing feeling in your feet can lead to blisters and sores, because you may not notice pressure or injuries. Diabetes can make these wounds hard to heal and raise the chance of infection. Sores and infections can lead to the loss of a toe, foot, or part of the leg. Finding and treating foot problems early lowers the chance of serious infection.
This nerve damage can also change the shape of your feet and toes. A rare problem called Charcot foot can damage the bones and tissue in the foot. Poor balance can lead to falls and fractures, which are broken bones.
Causes and who gets it
Over time, high blood sugar and high levels of fats called triglycerides can damage your nerves. They can also damage the small blood vessels that feed your nerves. Decreased blood flow adds to the problem. Nerve damage is more likely when blood sugar is not well controlled over time.
Some things raise the risk, including high blood sugar, having diabetes for many years, being overweight, being older than 40, and having high blood pressure or high cholesterol.
How doctors diagnose it
Doctors use your symptoms, your family and medical history, a physical exam, and tests. If you have diabetes, you should have a thorough exam of how you feel in your feet and legs at least once a year. Your doctor may:
- touch your feet with a tuning fork to see if you feel vibration
- touch your feet with a nylon strand, called a monofilament test
- look at how you walk and test your balance
Your doctor may also order blood tests to rule out other causes of nerve damage, such as thyroid problems, kidney disease, or low vitamin B12.
Treatment
Keeping your blood sugar, blood pressure, and cholesterol close to your goal numbers can keep nerve damage from getting worse.
Your doctor may prescribe medicine for nerve pain, such as certain antidepressants, seizure medicines, or skin creams, patches, or sprays. These medicines can help with pain, but they do not change the nerve damage. All medicines have side effects. If your pain does not improve, tell your doctor. Your doctor may also recommend physical therapy to improve strength and balance.
Daily foot care is important. Check your feet every day, and wear the right socks and shoes. Ask your doctor what to wear. Your doctor may send you to a podiatrist. Talk with your doctor before using supplements or any alternative medicine.
When to see a doctor
Call your doctor if you have any of these:
- A cut or sore on your foot that is infected or will not heal.
- Burning, tingling, weakness, or pain in your hands or feet that gets in the way of daily life or sleep.
If you notice any foot problems, call or see your doctor right away.
Call 911 or go to the emergency room if you faint, have trouble breathing, or are confused and hard to wake up.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Either can check your feet at visits, help manage your blood sugar plan, and refer you to a specialist when needed.
Common questions
Can diabetic peripheral neuropathy cause foot sores?
Yes, it can. If you lose feeling in your feet, you may not notice pressure or injuries that lead to blisters and sores. Diabetes can make these wounds hard to heal.
Why is foot care so important?
Foot care matters because nerve damage can hide injuries, so you may not feel a cut or blister. Checking your feet every day helps you find problems early. Finding and treating them early lowers the chance of serious infection.
Do nerve pain medicines fix the nerve damage?
No, they do not. These medicines can help with the pain, but they do not change the nerve damage.
How often should I have my feet checked by a doctor?
At least once a year, and more often if you have foot problems.
Sources
- NIDDK - Peripheral Neuropathy
- MedlinePlus - Diabetes and nerve damage
- CDC - Diabetes and Nerve Damage
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
