Diabetic neuropathy in the feet is nerve damage caused by diabetes, often linked to prolonged high blood sugar levels. It can cause numbness, tingling, burning or shooting pain, reduced sensation and problems with balance. Because loss of feeling can mean cuts, blisters or pressure sores go unnoticed, good foot care and properly fitting footwear are particularly important.
While nerve damage usually cannot be reversed, managing diabetes, checking your feet regularly and choosing footwear that reduces rubbing and pressure can help protect your feet and reduce the risk of complications.
I haven’t experienced diabetic neuropathy myself, but I’ve watched it affect someone close to me, and it’s given me a real appreciation for how serious the balance and falls risk actually is — not just the numbness itself. Watching a fall happen because a foot simply couldn’t feel the ground properly is something that sticks with you, and it’s exactly why I take footwear and daily foot checks so seriously when I write about this condition.
📌 At a Glance
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Jump straight to 10 Common Questions & Answers.
What Is Diabetic Neuropathy?
Diabetic neuropathy is nerve damage associated with diabetes, with prolonged high blood sugar being an important cause. It can affect the peripheral nerves — especially in the feet and lower legs — leading to numbness, reduced sensation, burning pain or hypersensitivity.
If your foot pain isn’t limited to this one condition, our Complete Guide to Foot Pain Relief walks you through all the main causes, treatments, and footwear tips to keep every step more comfortable.
Common Symptoms and Foot Problems
- Foot ulcers, which are a serious complication and need medical attention
- Numbness or reduced ability to feel pain or temperature
- Tingling, pins-and-needles, or burning sensations
- Sharp, stabbing, or shooting pain, which can be worse at night
- Muscle weakness or difficulty balancing
- Cuts, blisters or other injuries that may go unnoticed because of reduced sensation
Why the Right Shoes Matter
Footwear is particularly important when sensation in your feet is reduced. Shoes that rub or put pressure on the foot can cause blisters or sores that may not be noticed straight away, increasing the risk of further problems.
Useful footwear features to look for:
- Wide, deep toe boxes to avoid rubbing
- Soft, seamless interiors to reduce friction
- Cushioned midsoles for shock absorption
- Firm but flexible soles to support balance
- Removable insoles for custom orthotics
Wide-fit walking shoes or cushioned trainers may be suitable for some people, while specialist footwear may be recommended where there is significant loss of sensation, foot deformity or a history of ulceration.
Causes and Risk Factors
Diabetic neuropathy develops as a complication of diabetes. Prolonged high blood sugar can damage nerves and the small blood vessels that supply them.
The risk generally increases the longer someone has diabetes, particularly when blood sugar has been difficult to control. Other factors associated with a higher risk of diabetic neuropathy include:
- Kidney disease
- Smoking
- High blood pressure
- High cholesterol
- Being overweight or obese
Daily Foot Care
Daily care helps protect your feet from complications:
- Inspect feet daily — check for cuts, blisters, or colour changes
- Wash and dry carefully — especially between toes
- Moisturise — to prevent cracks, but avoid between toes
- Trim nails carefully — straight across to avoid ingrown nails
- Wear socks and shoes indoors — protect against unnoticed injuries
- Check shoes before wearing — remove stones or debris that could cause sores
If you have reduced sensation, poor circulation, a previous foot ulcer or difficulty caring for your own feet safely, ask your diabetes care team or podiatrist for individual advice.
When to Seek Medical Advice
Speak to your GP or diabetes care team if you develop new or worsening numbness, burning or pain in your feet, or if changes in sensation are beginning to affect your balance or walking.
If you have diabetes and develop a blister, cut, break in the skin or other foot wound that isn’t healing normally, don’t ignore it simply because it doesn’t hurt. Reduced sensation can make it difficult to judge how serious an injury is.
Seek prompt medical advice if you notice signs of infection such as increasing redness, warmth, swelling, discharge or pus, or if you feel generally unwell.
Depending on the problem, your GP, diabetes care team or podiatrist can assess sensation and foot health and advise on appropriate treatment or footwear. Medication may also be prescribed for neuropathic pain when needed.
Frequently Asked Questions About Diabetic Neuropathy in the Feet
Is numbness in the feet always caused by diabetic neuropathy?
No. Diabetes is one possible cause of numbness in the feet, but there are others. New, unexplained or worsening numbness should be assessed rather than assuming diabetes is responsible.
Can diabetic neuropathy affect balance?
Yes. Reduced sensation in the feet can make it harder to feel the ground beneath you, which may affect balance and increase the risk of falls.
Can diabetic neuropathy cause foot ulcers?
Reduced sensation can mean rubbing, pressure or a small injury goes unnoticed. This can contribute to the development of a foot ulcer, which is why regular foot checks are particularly important.
Are special diabetic shoes always necessary?
Not everyone with diabetic neuropathy needs specialist footwear. Shoes that fit properly, provide enough room for the toes and don’t create areas of rubbing or pressure may be suitable for some people. If you have significant loss of sensation, foot deformity or a history of ulceration, ask your diabetes care team or podiatrist about the most appropriate footwear.
What should I look for in shoes if I have reduced sensation?
Look for enough width and depth for your foot, a smooth interior without irritating seams, secure fastening and sufficient room around the toes. Check the inside of your shoes for rough areas or foreign objects before putting them on.
Should shoes for diabetic neuropathy be loose?
No. Extra room shouldn’t mean a shoe is loose enough for your foot to slide around inside it. The aim is a secure fit without unwanted pressure, rubbing or squeezing.
Are sandals suitable if I have diabetic neuropathy?
Open footwear leaves more of the foot exposed to knocks, cuts and other injuries. If you have reduced sensation, ask your podiatrist or diabetes care team whether your usual sandals provide enough protection for your feet.
Can insoles help?
Insoles can sometimes provide cushioning or redistribute pressure, but they also take up space inside the shoe. If you use an insole or orthotic, make sure there is still enough width and depth for your foot and toes.
Why should I check inside my shoes before putting them on?
If sensation is reduced, you may not immediately feel a small stone, damaged lining or other object inside the shoe. Checking first can help prevent avoidable rubbing or injury.
What should I do if I find a cut, blister or sore?
Don’t rely on pain to tell you whether an injury is serious if you have reduced sensation. Keep an eye on any damage to the skin and seek medical advice promptly if a wound isn’t healing normally or you notice signs of infection.
The Bottom Line
Diabetic neuropathy can make looking after your feet more difficult because reduced sensation means rubbing, pressure or a small injury may not always be obvious.
Managing diabetes itself belongs with your healthcare team, but there are practical things you can do for your feet. Check them regularly, don’t ignore cuts, blisters or sores, and choose shoes that fit securely without squeezing or rubbing.
For me, the biggest lesson from seeing neuropathy affect someone close to me is that loss of sensation isn’t something to dismiss simply because it doesn’t hurt. When your feet can’t reliably warn you that something is wrong, a comfortable, well-fitting pair of shoes becomes even more important.
Medical disclaimer: This article is for general information only and isn’t a substitute for medical advice, diagnosis or treatment. If you have diabetes and notice new or worsening numbness, pain, changes in sensation, or a wound or sore on your foot that isn’t healing normally, speak to your GP, diabetes care team or podiatrist.
About Sue Holland
Sue writes WiderFittingShoes.com from first-hand experience of finding footwear for wide and difficult-to-fit feet. After two hip replacements, two ankle replacements and years of dealing with arthritis, swelling and feet that don’t always behave the same from one day to the next, she shares the practical things she’s learned about shoe fit, width and comfort.