Symptoms of Diabetic Neuropathies

By  , Expert Content
Dec 22, 2011

Diabetes can affect any nerve at any time throughout the body. The four main types of diabetic neuropathy include:

  • Peripheral neuropathy.
  • Autonomic neuropathy.
  • Radiculoplexus neuropathy (diabetic amyotrophy).
  • Mononeuropathy (focal neuropathy).

A person may have symptoms of just one type or of the several types depending on the nerves that are affected. The nerve damage progresses slowly and the symptoms develop gradually. Therefore, the problems may not become evident until considerable damage has occurred. Some cases with type 2 diabetes may come to attention because of symptoms of neuropathy (even before diabetes is diagnosed). Signs and symptoms that a person may experience depends on the type of neuropathy and nerves that are affected.

Peripheral neuropathy

When the peripheral nerves in the body are damaged, it is known as peripheral neuropathy. It is the most common form of diabetic neuropathy. The ends of long nerves are affected first such as the nerves of the feet and legs followed by the nerves of hands and arms. Some signs and symptoms of peripheral neuropathy are:

  • Numbness or reduced sensation of pain or changes in temperature (most commonly in the feet and toes).
  • Tingling or burning sensation.
  • Sharp pain, which worsens at night.
  • Pain while walking.
  • Increased sensitivity to the lightest touch (such as some people may have agonizing pain even due to the weight of a thin sheet).
  • Weakness of muscles, which makes walking difficult.
  • Foot problems such as chronic ulcers, infections, deformities and bone and joint pain.


Autonomic neuropathy

When the autonomic nerves in the body are damaged, it is referred to as autonomic neuropathy. Autonomic nerves control functions such as heartbeat, blood pressure, sweating, digestion, urination, and sexual function. Autonomic neuropathy like most other complications of diabetes occurs in people with poorly controlled diabetes for many years. Diabetes can affect any autonomic nerve and cause symptoms such as:

  • Lack of awareness or decrease in blood sugar levels (hypoglycemia unawareness).
  • Bladder problems such as frequent urinary tract infections, urinary incontinence etc.
  • Bowel problems such as constipation, diarrhoea or a combination of the two.
  • Slow emptying of stomach (gastroparesis), which may cause nausea, vomiting and loss of appetite.
  • Sexual problems in men such as erectile dysfunction.
  • Sexual problems in women such as vaginal dryness and other sexual difficulties.
  • Increased or decreased sweating.
  • Inability of the body to maintain blood pressure and heart rate with change in posture. This may cause significant decrease in blood pressure when you rise from sitting or lying down (causing you to feel lightheaded or even faint).
  • Problems in maintaining the body temperature.
  • Difficulty in vision when it changes from light to dark.
  • Difficulty in doing exercises.
  • Rapid heart rate even at rest.


Radiculoplexus neuropathy (diabetic amyotrophy)

When the nerves closer to your hips or shoulders are affected rather than the nerve endings in peripheral neuropathy, it is known as radiculoplexus neuropathy (or diabetic amyotrophyor proximal neuropathy); it is most often seen in people with type 2 diabetes and older adults. In most cases, the legs are affected more commonly, but this type of neuropathy may affect other nerves such as those in the arms or even the abdomen. It usually involves one side of the body; therefore, the symptoms are usually on one side of the body, but in some cases the neuropathy may involve the other side too. Symptoms of diabetic amyotrophyor proximal neuropathy include:

  • Sudden, sharp and severe pain in the hip and thigh or buttock.
  • Weakening and atrophy of thigh muscles (as the disease progresses).
  • Difficulty in getting up from sitting position.
  • Unintended weight loss.
  • Abdominal swelling (in case the abdomen is affected).


Mononeuropathy (focal neuropathy)

In some cases, the disease may involve just one nerve such as nerve in the face, arm, wrist, thigh, or foot; this disease is known as mononeuropathy (or focal neuropathy). Symptoms of focal neuropathy occur suddenly and occur most often in older adults. Mononeuropathy can cause severe and sharp pain, but it doesn't cause any long-term problems as the symptoms reduce and disappear in some time (over few weeks or months). Some signs and symptoms of mononeuropathy (or focal neuropathy) include:

  • Difficulty in focusing your vision (it may cause double vision or pain behind one eye).
  • Paralysis or weakness on one side of the face (Bell's palsy).
  • Pain in leg (such as front of your thigh, shin or foot).
  • Pain in the front of your thigh.
  • Pain in chest or abdomen.
  • Pain on hand (when the nerve of the hand is compressed, it causes carpal tunnel syndrome, thereby leading to numbness or tingling in the fingers or hand, sense of weakness in hand, tendency to drop things etc)


Read more articles on  Diabetic Neuropathies Signs and Symptoms


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