Diabetic neuropathy can worsen over a period of many years. If it continues to progress, it can lead to potentially serious complications. Managing your blood sugar can help slow progression, especially for type 1 diabetes.

Untreated diabetes can lead to a range of complications. These include damage to the nerves in your body, or diabetic neuropathy (DN).

DN is the most common complication related to diabetes. According to the American Diabetes Association, about half of people with diabetes have some form of neuropathy.

DN can develop at any time. A 2022 paper notes that reduced nerve signaling can often occur early on in both type 1 diabetes (T1D) and type 2 diabetes (T2D).

Generally speaking, DN tends to worsen with age and the longer you’ve had diabetes. Because nerve damage can occur gradually over time, you may not notice any symptoms of neuropathy until many years after your diabetes diagnosis.

The development and progression of DN for T1D and T2D may also occur differently.

Type 1 diabetes

About 6% of adults with T1D develop a type of neuropathy called peripheral neuropathy (PN) at the time of diabetes onset. This increases to 30% after 13 to 14 years. PN refers to damage to the nerves outside the brain and spinal cord.

The 2022 paper mentioned before notes that nerve function quickly decreases after T1D develops. However, neuropathy progression slows significantly after 2 to 3 years.

When you manage your blood sugar properly, the progression of DN in T1D can often slow significantly or even stop.

Type 2 diabetes

Research notes that the prevalence of DN increases from 8% to 42% over 10 years in people with T2D. Progression of nerve damage in T2D also occurs at a steady rate after diagnosis.

Managing blood sugar is less effective at preventing the progression of DN in people with T2D. The reason for this is unknown, but it could be due to other underlying health conditions or risk factors.

Everybody is different and may experience diabetes complications differently.

Over the years, experts have proposed different staging systems for DN. These stages help categorize DN based on its symptoms and severity.

In the earliest stages of DN, you may not have any noticeable symptoms, though nerve damage can already be present.

As DN progresses, you may begin to experience symptoms like:

These symptoms may come and go at first. However, as neuropathy progresses into later stages, they can increase in frequency and may eventually become persistent.

The latest stages of DN are typically associated with complications related to the lower limbs, especially the feet, like:

  • foot sores, ulcers, or infections that heal very slowly
  • a complete loss of sensation in the feet
  • foot deformities, such as Charcot foot

Lower limb complications are common in diabetes, primarily if people don’t start to manage the condition early.

A 2020 study estimates that lower limb complications related to diabetes affected 131 million people globally in 2016. Most of these cases were associated with neuropathy and resulted in 6.8 million limb amputations.

Neuropathy in diabetes has the potential to reduce life expectancy, but this may depend on many factors.

A 2023 study found that the average survival time of older adults with PN in the limbs was reduced (10.8 years) compared with that of those without PN (13.9 years). Diabetes is a common cause of PN.

Additionally, a 2021 study found that diabetes-related PN was significantly associated with a higher chance of death due to any cause or death due to cardiovascular disease (CVD). The association between PN and CVD death was stronger in people who had lived with diabetes for a long time.

If it continues to progress, DN can also lead to serious foot complications. A different 2021 study looked into survival following the diagnosis of foot complications related to diabetes.

The average 5-year survival rate was 81.05%, meaning that roughly 4 in 5 study participants were alive within 5 years after a diagnosis of foot complications. Having CVD or an amputation reduced survival chances.

Generally speaking, the nerve damage that results from DN isn’t reversible. However, certain medications can reduce the pain associated with the condition if you already have it.

Managing your blood sugar can help slow the progression of neuropathy in diabetes. However, although blood sugar management slows progression in people with T1D, it’s less effective in T2D.

In addition to taking any diabetes medications as prescribed by a doctor, you can also try the following things to help lower your blood sugar:

It’s also important to monitor your blood sugar levels and check your feet for any problematic symptoms on a regular basis.

If you notice that your blood sugar is often above your target range or there are sores or ulcers on your feet, contacting a doctor is a priority.

DN is a common complication of diabetes. Your chance of developing it increases the longer you have diabetes.

Nerve damage is often present early on in diabetes. However, it may still be many years after your diabetes diagnosis before you begin to experience symptoms of DN.

If DN continues to progress, it can lead to complications that affect your quality of life and reduce your life expectancy. Managing your blood sugar can help slow DN’s progression, especially for people with T1D.