What Are the Symptoms of Diabetic Neuropathy?

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  • Common symptoms of diabetic neuropathy are known to involve the sensory, motor and autonomic (or involuntary) nervous systems
  • Some people with nerve damage may not manifest symptoms at all, and for others, they only experience mild symptoms such as numbness, tingling or pain in the feet

The symptoms of diabetic neuropathy depend on the type of the disease that affects a person and the nerves being targeted. Common symptoms are known to involve the sensory, motor and autonomic (or involuntary) nervous systems.

However, some people with nerve damage may not manifest symptoms at all, and for others, they only experience mild symptoms such as numbness, tingling or pain in the feet.

Mild cases may also remain unnoticed for a long period of time because most damage occurs over several years. Other people, typically those with focal neuropathy, can also experience sudden, severe and painful symptoms.1

Diabetic Neuropathy Symptoms Vary According to the Type of Condition

There are four types of diabetic neuropathy that can affect people, and symptoms are usually specific to a certain type of this disease.2

Peripheral neuropathy — Feet and legs are often affected first, followed by hands and arms. Patients with peripheral neuropathy may experience:

Numbness or reduced ability to feel pain or temperature changes

A tingling or burning sensation

Sharp pains or cramps

Increased sensitivity to touch

Muscle weakness

Loss of reflexes, especially in the ankle

Loss of balance and coordination

Serious foot problems such as ulcers, infections, deformities and bone and joint pain

Autonomic neuropathy — The disease targets the autonomic nervous system responsible for controlling the heart, bladder, lung, stomach, intestines, sex organs and eyes. Symptoms include:

Hypoglycemia unawareness (a lack of awareness that blood sugar levels are low)

Bladder problems including urinary tract infections or urinary retention or incontinence

Constipation, uncontrolled diarrhea or a combination of the two

Gastroparesis (slow stomach emptying), which can cause nausea, vomiting, bloating and appetite loss

Vaginal dryness and other sexual difficulties (women)

Erectile dysfunction (men)

Difficulty swallowing

Increased or decreased sweating

Changes in the way your eyes adjust from light to dark

Problems with body temperature regulation

Increased heart rate during rest

Inability of the body to adjust blood pressure and heart rate, causing sharp drops in blood after sitting or standing and leading to fainting or lightheadedness

Radiculoplexus neuropathy — Radiculoplexus neuropathy affects nerves in the thighs, hips, buttocks or legs. This condition is also called diabetic amyotrophy, femoral neuropathy or proximal neuropathy.

Typically, symptoms of radiculoplexus neuropathy are found on one side of the body, but in some cases these can spread to the other side:

Sudden and severe pain in your hip and thigh or buttock

Eventual weak and atrophied thigh muscles

Difficulty rising from a sitting position

Abdominal swelling if the abdomen is affected

Weight loss

Take note that most radiculoplexus neuropathy patients improve at least partially over time, but there are instances when symptoms can worsen before they get better.

Mononeuropathy — In this disease, there is damage to a specific nerve in the face, torso or leg. Mononeuropathy, also called focal neuropathy, often comes on suddenly. The symptoms of this type of diabetic neuropathy depend on the nerve involved, and can include:

Difficulty focusing your eyes, double vision or aching behind one eye

Paralysis on one side of the face (Bell’s palsy)

Pain in the shin or foot

Pain in the lower back or pelvis

Pain at the front of the thigh

Pain in the chest or abdomen

Mononeuropathy may also occur when a nerve is compressed. Among diabetics, carpal tunnel syndrome is a common type of compression neuropathy.

Patients can experience a numbness or tingling in the fingers or hand (especially in the thumb and/or index, middle and ring fingers), a sense of weakness in the hand and a tendency to drop things.

While mononeuropathy is known to trigger severe pain, this disease doesn’t usually cause long-term problems. Symptoms may disappear on their own within a few weeks or months.

If you notice these symptoms, talk to your doctor immediately to determine the type of diabetic neuropathy that may be affecting you so you can receive proper treatment.

Talk to Your Doctor if These Diabetic Neuropathy Symptoms Appear

Seek medical care as soon as possible if these severe indicators of diabetic neuropathy appear:3

A cut or sore on the foot that doesn't seem to be healing, is infected or is getting worse

Burning, tingling, weakness or pain in the hands or feet that interferes with sleeping or performance of daily routine

Dizziness

Changes in digestion, urination or sexual function

Although these particular symptoms don’t always indicate diabetic neuropathy, they can signal other problems that would already require medical care. If you see minor sores on the feet that don’t heal, have them treated immediately because they can turn into ulcers.

In severe cases, untreated foot ulcers can become gangrenous and spur tissue death, requiring surgery or amputation. Having symptoms diagnosed and treated as early as possible can offer the best chance for controlling these and preventing more severe problems from developing.

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