Diabetic Neuropathy

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Dr. Hersel’s apparent level of knowledge and expertise regarding my significant back situation is beyond reproach. He really makes you, the patient, feel like he cares about you and wants to help you and does in fact help.

- Geena Bigelow, Ventura, CA

Diabetic neuropathy is a type of nerve damage that can occur as a complication of diabetes. The areas of the body most commonly affected by diabetic neuropathy are the feet and the legs.

Causes/Risk Factors

  • Approximately 50% of people with diabetes will develop nerve damage. Most of the time, symptoms do not appear until 10 to 20 years after diabetes has been diagnosed.
  • Prolonged exposure to high blood sugar (glucose) can damage delicate nerve fibers, causing diabetic neuropathy.
  • Poor blood sugar control, kidney disease and the length of time a person has diabetes can all contribute to nerve damage.
  • Smoking and alcohol abuse can contribute to the development of diabetic neuropathy.


  • Diabetic neuropathy symptoms can range from pain and numbness in your extremities to problems with your digestive system, urinary tract, blood vessels and heart.
  • For some people, the symptoms of diabetic neuropathy are mild; for other, the condition can be painful, disabling and even fatal.
  • Symptoms can develop slowly, over several years, and can vary depending on the nerves that are affected.
  • Other symptoms of diabetic neuropathy nerve may include:
    • Numbness, tingling or pain in the toes, feet, legs, hands, arms and fingers
    • Wasting of the muscles of the feet or hands
    • Indigestion, nausea or vomiting
    • Diarrhea or constipation
    • Dizziness of faintness due to a drop in blood pressure after standing or sitting up
    • Problems with urination
    • Erectile dysfunction in men or vaginal dryness in women
    • Weakness


  • Diabetic neuropathy is diagnosed based on the patient’s range of symptoms and a physical examination. During the exam, blood pressure, heart rate, muscle strength, reflexes and sensitivity to vibration, temperature, touch and position changes may be tested. Blood tests may also be taken.
  • Nerve conduction studies or electromyography (EMG) can be used to help determine the type and extent of nerve damage.


At PMIR Medical Center, we understand that pain is a complex condition that affects the whole person—body, mind and spirit. We provide a comprehensive, multidisciplinary approach to treatment, customizing the most effective treatment plans for our patients and empowering them to become a collaborative partner in their recovery process.

The first step in the treatment of diabetic neuropathy is to get your blood sugar in a healthy range. This may include learning the basic steps for managing your diabetes and avoiding its complications. It may also mean checking your blood sugar once a day or more and making some lifestyle changes.

We offer treatment options for diabetic neuropathy that include:

We specialize in non-medication-based therapies to help our patients achieve sustained pain relief. However, we do offer pain medication, when necessary, as a supplement to other treatment options.

We may also recommend complementing your treatment at PMIR with complementary and alternative medicine (CAM) options that include:

  • Acupuncture
  • Biofeedback
  • Massage therapy

To learn more about how we treat diabetic neuropathy and the treatment plan that might be best for you, schedule an appointmentwith a PMIR physician today.

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PMIR Pain Checker

The PMIR symptom checker is intended for educational purposes only. PMIR encourages patients to educate themselves on all pain symptoms and the treatments we provide. However, we recommend anyone who may be suffering from any pain to not self-diagnose, or to supplement seeking medical advice with information on our site. If you are in pain, or have a medical emergency contact one of our offices or dial 911.