Type 2 diabetes is associated with neuropathic symptoms, including development of peripheral neuropathy and an exaggerated exercise pressor reflex, both of which have been demonstrated in UC Davis Type 2 diabetes mellitus (UCD-T2DM) rats. This novel animal model more closely mimics the human disease state than traditional T2DM rodent models. Several studies have demonstrated changes in nerve growth factor (NGF) in diabetic patients, with some showing increases and others decreases, and this has been proposed as a potential driver of the development of peripheral neuropathy. Additionally, increased expression of purinergic 2X3 (P2X3) receptors has been suggested as a potential mechanism underlying peripheral nerve sensitization. However, interactions between these factors during diabetes progression are not fully understood. Therefore, the objective of this study was to investigate the relations between NGF, P2X3, and peripheral neuropathy during diabetes progression in UCD-T2DM rats. We hypothesized that NGF levels would be correlated with traditional indexes of diabetes (glucose and HbA1c) as well as P2X3 expression and mechanical allodynia as measured by paw withdrawal threshold. Methods Blood was collected monthly from the tail vein of male UCD-T2DM rats from 4 to 8 months of age. Serum levels of NGF, leptin, and insulin were measured by ELISA. Development of mechanical allodynia was tracked monthly using Von Frey filaments to measure paw withdrawal threshold. At 8 months of age, L4-5 dorsal root ganglia were harvested and P2X3 receptor protein levels were quantified using the Jess automated western blotting platform. Pearson correlations were calculated using Graphpad Prism 9. Results Consistent with wasting and loss of pancreatic beta cell function during diabetes progression, glucose and HbA1c increased significantly over time whereas body weight, insulin, and leptin levels decreased. Circulating NGF concentration was negatively correlated with glucose (r=-0.61, P<0.01) and HbA1c (r=-0.79, p<0.01) demonstrating that NGF decreased with the progression of diabetes. Circulating NGF concentration was positively correlated with body weight (r=0.61, p<0.01), insulin (r=0.77, p<0.01), and leptin (r=0.82, p<0.01) thereby showing the same decreasing trend with diabetes progression. Interestingly, NGF was negatively correlated with P2X3 receptor expression (r=-0.81, p=0.03) and neither NGF nor P2X3 were significantly associated with mechanical allodynia (NGF: r=0.14, p=0.45; P2X3: r= 0.15, p=0.75). Conclusion Circulating NGF is significantly associated with several indexes of diabetes progression in UCD-T2DM rats, including glucose, HbA1c, leptin, and insulin levels. Though decreasing concentrations of NGF are associated with increases in P2X3 receptor protein expression, neither NGF nor P2X3 appear to be associated with the development of mechanical allodynia.