What is Diabetic Neuropathy?
Reviewed by Dr. Nileshkumar Patel, M.D., M.B.A.
Diabetic neuropathy is a painful condition caused by nerve damage from diabetes. The damage can occur throughout the body, but is most common in the legs, feet and hands and can lead to symptoms of burning pain and numbness.1
Diabetes leads to high levels of blood glucose (commonly known as blood sugar), and prolonged elevation of blood glucose is believed to cause nerve damage. Over time, this can cause numbness, tingling, and pain, especially in the extremities. As many as half of all adults with diabetes may develop diabetic neuropathy during their lifetime.2,3
What are the different types of Diabetic Neuropathy?
There are three main types of diabetic neuropathy, affecting different parts of the body, each with distinct clinical impacts.
Symmetrical Peripheral Neuropathy
Peripheral neuropathy is the most common type of diabetic neuropathy. It usually affects the feet and legs first, and symptoms may begin with a loss of sensation. Pain and discomfort in the feet are common and may feel like tingling or burning, or a sharp, jabbing pain. Diabetic foot pain can be so severe that even the lightest touch can be hard to tolerate.
Autonomic neuropathy affects the nervous system that controls automatic body functions – including, for example, your heartbeat, breathing, and digestion. As you may expect, symptoms might include digestive problems, dizziness from blood pressure issues, loss of bladder control, and sweating problems.
Focal neuropathy (also called mononeuropathy) is damage to a single nerve, which can be in any part of the body, including the face. Symptoms can include numbness or tingling, weakness in hands making it difficult to hold things, foot pain, and paralysis on the side of the face.
Who is most likely to get Diabetic Neuropathy?
Anyone diagnosed with diabetes is at risk of developing diabetic neuropathy. To lower your risk, you should practice good blood sugar management and adopt a lifestyle that includes frequent exercise, weight management. and a healthy diet.
What are common treatments for Diabetic Neuropathy?
Because there is no cure for diabetic neuropathy, the American Diabetic Association (ADA) recommends tight glucose control as the primary method for preventing or slowing down the progression of the condition, relieving diabetic pain and discomfort, and managing complications. The FDA has approved duloxetine, pregabalin, and tapentadol as oral agents, and capsaicin patches for topical application, but the ADA does not recommend tapentadol as it has weak opioid activity.5 Unfortunately, not everyone responds to these drugs and many people find the side-effects hard to tolerate for sustained periods of time. The reality for most diabetic neuropathy patients is that there is tremendous pain, suffering, and functional impairment, calling for new approaches to treating diabetes.6
Diabetic Peripheral Neuropathy and Spinal Cord Stimulation
An encouraging recent development for patients with Diabetic Peripheral Neuropathy (DPN) is that Spinal Cord Stimulation (SCS) has now been approved by the FDA as a treatment to relieve the pain they may be experiencing in the lower legs and feet.*
SCS therapy uses a small, implanted device that delivers mild electrical pulses to interrupt pain signals coming from the affected part of the body. Boston Scientific’s SCS therapy has provided significant, lasting relief from neuropathic pain for more than 20 years. And in a recent clinical study spanning three years, 90% of DPN patients reported sustained improvement with Boston Scientific’s SCS therapy.4
SCS therapy is fully reversible and patients can take a trial first to see if it works for their particular pain.
This short video explains how SCS works:
Diabetic neuropathy is a serious condition affecting many people living with diabetes.
There are three main types of diabetic neuropathy – Autonomic, Focal, and Peripheral.
Careful blood sugar management, diet, and exercise may help avoid or delay the progression of diabetic neuropathy.
People living with Diabetic Peripheral Neuropathy (DPN) now have the option of SCS therapy to help manage the pain and discomfort they may feel in their lower extremities.
Only a pain management specialist can help you determine if SCS may be right for your specific pain. If you have been diagnosed with DPN, you can learn more about SCS for DPN here or you can call to speak to one of our Patient Education Specialists at 877.473.0844, 5:30am – 5pm PT, M-F. They can connect you to doctors in your community with the expertise to discuss if SCS therapy is appropriate for you.
Wondering if Spinal Cord Stimulation may be right for you?
Take this quick quiz and find out. ⟶
* Only paresthesia-based stimulation mode has been evaluated for effectiveness in the diabetic peripheral neuropathy (DPN) population.
1. Mayo Clinic. Diabetic neuropathy symptoms. https://www.mayoclinic.org/diseases-conditions/diabetic-neuropathy/symptoms-causes/syc-20371580. Accessed October 5, 2023.
2. American Diabetes Association. Statistics about diabetes. https://diabetes.org/about-diabetes/statistics/about-diabetes Accessed October 8, 2023.
3. Hicks, C.W., Selvin, E. Epidemiology of Peripheral Neuropathy and Lower Extremity Disease in Diabetes. Curr Diab Rep 19, 86 (2019). https://doi.org/10.1007/s11892-019-1212-8
4. Chaiban G, et al. Real-World Outcomes in PatientsUsing SCS for Treatment of Painful Diabetic Peripheral Neuropathy (DPN) [Abstract]. Twenty-sixth Annual Meeting of the North American Neuromodulation Society, January 13-15th, 2023. (n=24 @ 1 year, n=16 @ 2 years, & n=12 @ 3 years, Ongoing study)
5. Pop-Busui R, Ang L, Boulton AJM, Feldman EL, Marcus RL, Mizokami-Stout K, Singleton JR, Ziegler D. Diagnosis and Treatment of Painful Diabetic Peripheral Neuropathy. Arlington (VA): American Diabetes Association; 2022 Feb. PMID: 35544662
6. Yeung AM, Huang J, Nguyen KT, Xu NY, Hughes LT, Agrawal BK, Ejskjaer N, Klonoff DC. Painful Diabetic Neuropathy: The Need for New Approaches. J Diabetes Sci Technol. 2022 Oct 28:19322968221132252.