Can Diabetic Neuropathy be Reversed?

Diabetic neuropathy or nerve damage is a very common complication affecting as many as half the people with diabetes.[1] Over time, high blood glucose levels or blood sugar, and high levels of fats, such as triglycerides, in the blood from diabetes can damage nerves.[2] When this happens, the nervous system’s signaling can no longer work correctly.[3]

There are several types of neuropathies, among them:

Peripheral: Affects the peripheral nervous system, resulting in pain and numbness in the extremities, including arms, hands, legs, feet, and toes. Since peripheral neuropathy can cause numbness, someone with diabetes might not feel a foot injury, cut or even a blister that could result in an ulcer. Foot ulcers are a considerable problem for people with diabetes often leading to hospitalization.

Proximal: Pain and numbness in the upper legs, specifically the buttocks, thighs, and hips. This type of nerve damage typically affects one side of the body and may rarely spread to the other side. It is more common in men than in women and more common in people older than age 50. Most people with this condition have type 2 diabetes.[4]

Autonomic: This nerve damage disturbs signal processing between the autonomic nervous system and the brain. Injured autonomic nerves can affect:[5]

• blood pressure
• heart rate
• perspiration patterns
• bowel movements
• bladder emptying
• digestion

Focal: Sudden loss of function in nerves causing pain and weakness of the muscles. Carpal tunnel syndrome is a type of focal neuropathy.

Slow progression and reduce further harm

Neuropathy caused by diabetes cannot be reversed, since the body cannot naturally repair damaged nerve tissues. [6] Keeping blood sugars within the target range is critical. The key to healthy eating is to eat a variety of healthy foods from all the food groups - vegetables, fruits, grains, protein, and dairy (nonfat or low fat) - in the amount established in a meal plan tailored to specific needs. Also eating healthy means to eating foods with heart-healthy fats, which come from: [7]

• oils that are liquid at room temperature, such as canola and olive oil
• nuts and seeds
• heart-healthy fish such as salmon, tuna, and mackerel
• avocado

Limit fried foods and other foods high in saturated and trans fats, foods high in salt, sweets and beverages with added sugars.

Manage peripheral neuropathy

Peripheral neuropathy is the most common type of diabetic neuropathy. [8] In addition to eating healthy to keep blood sugars in the target range, diabetics should check their feet daily for:

• Dry and cracked skin
• Blisters or sores
• Bruises or cuts
• Redness, warmth, or tenderness (often absent because of nerve damage)
• Firm or hard spots

The American Diabetes Association recommends[9] having a foot exam once a year and more often for those with problems.  If peripheral neuropathy is detected, focus on keeping feet healthy and managing pain.

[1] “Diabetic Neuropathy,” Mayo Clinic, Accessed January 25, 2023. https://www.mayoclinic.org/diseases-conditions/diabetic-neuropathy/symptoms-causes/syc-20371580

[2] “Diabetic Neuropathy,” NDDK, Accessed January 25, 2023. https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-problems/nerve-damage-diabetic-neuropathies

[3] Huizen, Jennifer, “Is it possible to reverse diabetic neuropathy,” Medical News Today, May 7, 2019. https://www.medicalnewstoday.com/articles/317923

[4] “Proximal Neuropathy,” National Institute of Diabetes and Digestive and Kidney Disease (NIDDK), Accessed January 23, 2023. https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-problems/nerve-damage-diabetic-neuropathies/proximal-neuropathy#what

[5] Allen, Suzanne, “Autonomic Neuropathy,” healthline, August 24, 2017.

https://www.healthline.com/health/autonomic-neuropathy

[6] Neel, Duggal, “Diabetic Neuropathy: Can It Be Reversed,” healthline, February 5, 2020. https://www.healthline.com/health/diabetes/can-diabetic-neuropathy-be-reversed

[7] “Diabetes Diet, Eating& Physical Activity,” NDDK, Accessed January 25, 2023. https://www.niddk.nih.gov/health-information/diabetes/overview/diet-eating-physical-activity

[8] “Diabetic Neuropathy,” Mayo Clinic

[9] “Peripheral Neuropathy,” American Diabetes Association,” Accessed January 25, 2023, https://www.diabetes.org/diabetes/neuropathy/peripheral-neuropathy