Diabetic neuropathy types: Symptoms tell the story

There are four main types of diabetic neuropathy — nerve damage that can occur as a result of high blood sugar when you have diabetes. You may have just one type or symptoms of several types. Most types of diabetic neuropathy develop gradually, and you may not notice problems until considerable damage has occurred.

Talk to your doctor about any of the following symptoms. The sooner they can be diagnosed and treated, the better the chance of preventing further complications.

Peripheral neuropathy

Peripheral neuropathy is the most common form of diabetic neuropathy. Your feet and legs are often affected first, followed by your hands and arms. Possible signs and symptoms of peripheral neuropathy include:

  • Numbness or reduced ability to feel pain or changes in temperature, especially in your feet and toes
  • A tingling or burning feeling
  • Sharp, jabbing pain that may be worse at night
  • Pain when walking
  • Extreme sensitivity to the lightest touch — for some people even the weight of a sheet can be agonizing
  • 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, possibly causing:

  • A lack of awareness that blood sugar levels are low (hypoglycemia unawareness)
  • Bladder problems, including frequent urinary tract infections or urinary incontinence
  • Constipation, uncontrolled diarrhea or a combination of the two
  • Slow stomach emptying (gastroparesis) leading to nausea, vomiting and loss of appetite
  • Difficulty swallowing
  • Erectile dysfunction in men
  • Vaginal dryness and other sexual difficulties in women
  • Increased or decreased sweating
  • Sharp drops in blood pressure when you rise from sitting or lying down that may cause you to feel lightheaded or faint (orthostatic hypotension)
  • Problems regulating your body temperature
  • Changes in the way your eyes adjust from light to dark
  • Increased heart rate when you're at rest
May. 15, 2014 See more In-depth