Diabetic neuropathy: Symptoms - MayoClinic.com

/Home/Complications of Diabetes/Diabetic Neuropathy (Nerve Damage)/Symptoms of Diabetic Neuropathy

Diabetic neuropathy: Symptoms - MayoClinic.com
Jan. 16, 2008
By Mayo Clinic Staff
MayoClinic.com

There are four main types of diabetic neuropathy. You may have just one type or symptoms of several types. Most develop gradually, and you may not notice problems until considerable damage has occurred. For some people, symptoms of neuropathy develop before diabetes is ever diagnosed.

The signs and symptoms of diabetic neuropathy vary, depending on the type of neuropathy and which nerves are affected:

Peripheral neuropathy
Peripheral neuropathy is the most common form of diabetic neuropathy. It damages nerves in your feet, legs, arms and hands, but your legs and feet are affected most often. Symptoms include:

* Numbness or reduced ability to feel pain or changes in temperature, especially in your feet
* A tingling, burning or prickling sensation that starts in your toes or the balls of your feet and gradually spreads upward
* Sharp, jabbing or electric shock-like pain that's worse at night
* Extreme sensitivity to the lightest touch — for some people, even the weight of a sheet can be agonizing
* Loss of balance and coordination
* Muscle weakness and difficulty walking
* Serious foot problems, such as ulcers, infections, deformities, and bone and joint pain

Autonomic neuropathy
The autonomic nervous system controls your heart, bladder, lungs, stomach, intestines, sex organs and eyes. Diabetes can affect the nerves in any of these areas, causing:

* Bladder problems, including frequent urinary tract infections or urinary incontinence
* Digestive problems, such as bloating, belching and abdominal pain
* Constipation, uncontrolled diarrhea or a combination of the two
* Slow stomach emptying (gastroparesis), leading to nausea, vomiting and loss of appetite
* Erectile dysfunction, which affects more than half the men with diabetes who are age 60 or older
* Vaginal dryness and other sexual difficulties in women
* Increased or decreased sweating
* Inability of your body to adjust blood pressure and heart rate, leading to sharp drops in blood pressure after sitting or standing (orthostatic hypotension)
* Problems regulating your body temperature
* Changes in the way your eyes adjust from light to dark

Autonomic neuropathy is most likely to occur in people who have had poorly-controlled diabetes for many years.

Proximal neuropathy
Also called femoral neuropathy or diabetic amyotrophy, proximal neuropathy is often marked by severe pain in your hip and thigh or buttocks, usually beginning on one side of your body. Eventually, your thigh muscles become weak and atrophied, making it difficult to rise from a sitting position. Many people have severe weight loss as well. Another form of this disorder causes severe pain in the trunk of your body. Proximal neuropathy mainly affects older adults and people with type 2 diabetes.

Focal neuropathy
Focal neuropathy often comes on suddenly and usually involves a single nerve. It's most common in older adults. Although focal neuropathy can cause severe pain, it usually goes away on its own in a few weeks or months. Signs and symptoms include:

* Difficulty focusing your eyes, double vision or aching behind one eye
* Paralysis on one side of your face (Bell's palsy)
* Pain in your shin or foot

Sometimes focal neuropathy occurs when a nerve is compressed. Carpal tunnel syndrome is the most common type of compression neuropathy in people with diabetes.

Signs and symptoms of carpal tunnel syndrome include:

* Numbness, swelling or tingling in your fingers when driving a car or holding a newspaper
* Pain radiating or extending from your wrist up your arm to your shoulder or down into your palm or fingers, especially after forceful or repetitive use
* A sense of weakness in your hands and a tendency to drop objects


© 1998-2009 Mayo Foundation for Medical Education and Research (MFMER). All rights reserved. A single copy of these materials may be reprinted for noncommercial personal use only. "Mayo," "Mayo Clinic," "MayoClinic.com," "EmbodyHealth," "Reliable tools for healthier lives," "Enhance your life," and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation for Medical Education and Research.