Diabetic neuropathy is damage to the peripheral and autonomic nerves caused by long-term elevated blood sugar levels. It is one of the most common long-term complications of diabetes and can affect sensory, motor and autonomic nerves.
shapes
| shape | Affected nerves | Typical symptoms |
|---|---|---|
| Peripheral sensorimotor neuropathy | Sensory and motor nerves of the extremities | Tingling, numbness, burning pain, unsteady gait (“stocking-like”) |
| Autonomic neuropathy | Vegetative nervous system | Cardiac arrhythmias, digestive problems, bladder disorders, erectile dysfunction |
| Focal neuropathy | Individual nerves | Sudden paralysis or severe pain (e.g. eye muscles, thighs) |
Causes and risk factors
The main cause is chronic hyperglycemia. Other risk factors include:
- Long duration of diabetes
- Poor long-term blood sugar control (high HbA1c)
- Old age
- Smoking
- High blood pressure and lipid metabolism disorders
Symptoms
The symptoms usually develop gradually and often affect the feet first:
- Tingling, numbness or “pins and needles” (especially at night)
- Burning or stabbing pain
- Disturbed temperature sensitivity
- Muscle cramps and weakness
- In the autonomic form: dizziness when standing up, indigestion, sexual dysfunction
Diagnostics
The investigation includes:
- Clinical tests (vibration sensation with tuning fork, monofilament test on the feet)
- Measurement of nerve conduction velocity
- Quantitative sensory testing
Therapy and prevention
The most important measure is the best possible blood sugar control. Other therapies:
- Pain treatment (e.g. pregabalin, duloxetine, alpha lipoic acid)
- Regular foot care and podiatry check-ups
- Physiotherapy and balance training
Further information:
→ Diabetes mellitus – knowledge and overview
→ Why hyporest
→ Type 2 diabetes
Sources
- German Diabetes Society (DDG). S3 guideline “Diabetic neuropathy”. As of 2025. Available at: www.deutsche-diabetes-gesellschaft.de/leitlinien.
- American Diabetes Association. Standards of Medical Care in Diabetes—2026. Diabetes Care. 2026;49(Suppl 1). Available at: diabetesjournals.org.
- Robert Koch Institute (RKI). Federal health reporting – diabetes mellitus in Germany. Berlin 2024.
- International Diabetes Federation (IDF). IDF Diabetes Atlas. 11th edition. Brussels 2025. Available at: diabetesatlas.org.
Important note:
The information in this encyclopedia article is intended solely for general and non-binding information. They do not replace medical advice, diagnosis or therapy. If you have any health questions or complaints, please always consult a doctor or qualified healthcare professional. The content was created with the greatest possible care, but errors cannot be completely ruled out.
Last updated: February 26, 2026
