How Neuropathy Symptoms Affect Quality of Life in Diabetes
Danique Mocking, Sabita S. Soedamah-Muthu, Giesje Nefs, Elizabeth Holmes-Truscott, Marjolein M. Iversen, Loretta Vileikyte, Christophe De Block, Mariska Bot, Patrick Vriens and Frans Pouwer.
The associations between different types of diabetes neuropathy symptoms and neuropathy-specific quality of life: Results from the diabetes MILES the Netherlands study. J Diabetes Complications. 2026 Nov;40(11):109398. Epub 2026 Sep 1.
Diabetic neuropathy, a common complication of diabetes involving nerve damage, can cause pain, numbness, reduced sensitivity and difficulties with balance or movement. These symptoms can affect daily activities and quality of life. However, less is known about how different types of neuropathy symptoms are associated with quality of life.
In this study, co-authored by Diabeter NL/Diabeter Center Amsterdam author Giesje Nefs, Mocking and colleagues analysed data from 1,324 adults with diabetes participating in the Dutch Diabetes MILES study, including 583 people with type 1 diabetes (T1D) and 741 with type 2 diabetes (T2D). Using questionnaires, the researchers examined how different neuropathy symptom profiles were associated with neuropathy-specific quality of life.
Key findings:
- Multiple symptoms had the greatest impact: People experiencing several types of neuropathy symptoms reported the poorest neuropathy-specific quality of life in both T1D and T2D.
- All symptom types were associated with lower quality of life in T1D: Pain, reduced sensitivity and diffuse sensory-motor symptoms were each significantly associated with poorer quality of life compared with having no neuropathy symptoms.
- Similar findings were observed in T2D: Pain and diffuse sensory-motor symptoms were significantly associated with lower quality of life. Reduced sensitivity alone showed a similar trend, but the difference was not statistically significant.
- No clear differences between individual symptom types: Pain, reduced sensitivity and diffuse sensory-motor symptoms did not differ significantly from one another in their associations with quality of life.
- Additional factors played a role: In T1D, poorer neuropathy-specific quality of life was associated with more diabetes complications, older age and higher BMI. In T2D, more complications, higher anxiety levels and male sex were associated with poorer quality of life.
The findings highlight the importance of recognising different neuropathy symptoms, including those that may be less noticeable, such as reduced sensitivity. Assessing symptom profiles alongside their impact on daily life may support more personalised diabetes care. Because the study was based on self-reported information collected at one point in time, it cannot establish cause and effect. Further research is needed to confirm these associations and their clinical relevance.
Concluding, the authors state
“In conclusion, the findings of this study indicate that all types of DN symptoms contribute meaningfully to NS-QoL.”
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