Medical Oncologist
Nerve side effects
Nerve damage from chemotherapy when you have diabetes
Diabetes and some chemotherapy drugs both damage the nerves of the hands and feet, so people with diabetes are more likely to develop numbness, may notice it later, and have more to lose from foot injuries. Steroids given with treatment can also push blood sugar up. Careful sugar control, daily foot checks and early reporting make a real difference.
NG
Medically reviewed by Dr. Naresh GunduConsultant Medical Oncologist · MBBS, DNB (Internal Medicine), DM (Medical Oncology, AIIMS) · last reviewed September 2026, next review due September 2027
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The short answer
Is nerve damage from chemotherapy worse if you have diabetes?
It can be. Diabetes and some chemotherapy drugs both damage the nerves of the hands and feet, and the two effects add together. People with diabetes are more likely to develop chemotherapy numbness, may develop it sooner or more severely, and may not notice it early because some feeling was already reduced. They also have more to lose, because diabetes slows healing and raises the risk that a small foot injury becomes a serious infection.
Diabetes is very common among people having cancer treatment in India, so this is not a rare situation. It does not usually mean chemotherapy cannot be given. It means the team needs to know about your diabetes and any existing nerve problems at the start, blood sugar needs closer attention, and foot care needs to be taken seriously every day.
Tell your oncologist about diabetes and existing numbness
This can influence which drugs are chosen, how closely nerves are watched, and when a dose change is considered.
Steroids can push blood sugar up
Steroids given with many chemotherapy regimens raise blood sugar, sometimes sharply. Your diabetes medicines may need adjusting around treatment days.
Feet need daily checks
With two causes of numbness, a daily look at the feet is the most reliable way to catch injuries before they become serious.
Ask whether your oncology team and your diabetes doctor are sharing information about your treatment.Why the risk is higher
How diabetes and chemotherapy combine
- Nerves already under strain
- Long-standing high blood sugar damages nerves. Chemotherapy then adds to damage that may already be present, even if it was mild or unnoticed before.
- Symptoms noticed later
- If feeling was already reduced, new chemotherapy numbness may not be noticed until it is more advanced, which is why checks and reporting matter.
- Blood sugar swings from steroids
- Steroids given with treatment, stress, infection and changes in eating can all push sugar up or make it unpredictable during a course.
- Appetite and eating changes
- Nausea, mouth sores and poor appetite can cause low blood sugar in people on insulin or some tablets, especially if doses are not adjusted.
- Slower healing and higher infection risk
- Diabetes slows wound healing and weakens defence against infection, on top of the effects of chemotherapy and low blood counts.
- Circulation problems
- Some people with diabetes have reduced blood flow to the feet, which further slows healing of any injury.
Not sure whether this applies to you?
Ask an oncologistPractical
Managing diabetes and nerves through treatment
Sugar control, foot care and good communication.
Check blood sugar more often
Especially on steroid days and during illness or poor eating. Ask your team or diabetes doctor how often to test and what readings should prompt a call.
Write down
- Readings with the date and time
- Steroid and treatment days
Do not adjust medicines alone
Ask your diabetes doctor or oncology team how to adjust tablets or insulin around treatment, steroids and poor appetite, rather than guessing.
Check feet every day
Tops, soles, heels and between the toes, using a mirror or a helper. Look for cuts, blisters, cracks, redness, swelling or nail problems.
Always
- Wear closed, well-fitting shoes
- Test water temperature by hand
Report nerve changes early
Tell your team about any new or worsening numbness, tingling or pain before each cycle, even if you already had some numbness from diabetes.
Ask about specialist foot care
A diabetic foot clinic or podiatrist can check your feet, treat corns, calluses and nails safely, and advise on footwear.
!
Get medical help the same day, or immediately, for any of these
A foot wound, blister or crack that is red, warm, swollen, painful or discharging · a foot that becomes cold, pale, blue or very dark · a fever at or above your team's threshold, especially with a foot wound · very high blood sugar readings with thirst, vomiting, confusion or drowsiness · low blood sugar with sweating, shaking, confusion or collapse that does not recover with sugar · sudden weakness of an arm, leg or the face. Go to the nearest emergency department and say clearly that the person has diabetes and is on chemotherapy.
Being straight with you
What this page cannot tell you
It cannot give blood sugar targets or medicine doses. Those depend on your type of diabetes, medicines, kidney function, treatment and eating, and must come from your diabetes doctor or oncology team. Many people need their plan adjusted during chemotherapy.
It also cannot tell you which chemotherapy drugs are best for you. Diabetes and existing nerve damage are among the factors your oncologist weighs, alongside the type and stage of cancer and the aim of treatment.
Diabetes rarely rules out treatment
Most people with diabetes can have chemotherapy. What changes is the level of monitoring and care around sugar, nerves, kidneys and feet.
Kidney function matters too
Diabetes can affect the kidneys, and some chemotherapy drugs and diabetes medicines are processed by the kidneys. Your team will check kidney tests regularly.
Nerve pain medicines need checking
If you develop nerve pain, some medicines need adjusting for kidney function or can affect blood sugar or weight. Your team will choose carefully.
Family can help with checks and records
A relative can help check feet, record sugar readings and notice confusion or symptoms of low sugar, especially on difficult treatment days.
Carry sugar and your diabetes details
Keep glucose tablets or sweets with you on treatment days, and carry a note of your diabetes medicines. If nausea stops you eating or your sugar drops, you and the staff can act quickly.
What to do next
Tell your oncologist about your diabetes and any existing numbness before treatment starts. Ask how to monitor and adjust your diabetes medicines around steroids and poor appetite, check your feet every day, report nerve changes before each cycle, and ask about a diabetic foot clinic.
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Commonly believed
Four beliefs about diabetes and chemotherapy
"I already have numb feet from diabetes, so chemotherapy will not change anything."
Chemotherapy can add to existing damage, making numbness worse or spreading it further. Report any change, even if you were numb before.
"My sugar is controlled, so I do not need to check it more."
Steroids, stress, infection and eating changes during treatment can disrupt even well-controlled diabetes. More frequent checks help catch swings.
"If I am not eating, I should take my usual insulin anyway."
Poor appetite can lead to low blood sugar on usual doses. Ask your doctors how to adjust medicines when eating changes.
"A small foot wound is nothing to worry about."
With diabetes and chemotherapy together, small wounds heal slowly and infect easily. Report any foot wound the same day.
Questions we are asked
Common questions about diabetes and nerve damage
Does diabetes increase the risk of chemotherapy numbness?
Yes. Diabetes can already damage nerves, and chemotherapy adds to that damage. People with diabetes may develop numbness more easily or more severely.
Can I still have chemotherapy with diabetes?
Usually yes. Your oncologist considers your diabetes and any existing nerve damage when planning treatment, and you will need closer monitoring of sugar, kidneys and feet.
Why is my sugar high after treatment?
Steroids given with many regimens raise blood sugar, often for a few days. Stress and infection can too. Ask your team how to monitor and adjust your diabetes medicines.
What if I cannot eat because of nausea?
Contact your team or diabetes doctor, as your medicines may need adjusting to avoid low blood sugar. Do not simply continue usual doses without advice.
How should I care for my feet?
Check them daily, wear closed well-fitting shoes, test water temperature by hand, keep skin moisturised but dry between toes, and report any wound the same day.
Should my diabetes doctor know about my chemotherapy?
Yes. Share your treatment plan, steroid schedule and blood test results with them, and ask whether they and your oncology team are coordinating care.
Will my numbness go away after treatment?
The chemotherapy part may improve over months, but existing diabetic nerve damage usually remains. Good sugar control supports recovery and protects against further damage.
Can nerve pain medicines affect my diabetes?
Some can affect weight, blood sugar or need adjusting for kidney function. Your team will choose and monitor them with your diabetes in mind.
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Sources
- American Diabetes Association — Foot Complications
- National Cancer Institute — Chemotherapy and You: Support for People With Cancer
- Cancer Research UK — Side effects of chemotherapy
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
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