Diabetic neuropathy types: Symptoms tell the story

By Mayo Clinic Staff

When you have diabetes, nerve damage can occur as a result of high blood sugar. This is known as diabetic neuropathy. There are four main types of this condition. 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 with your doctor if you have 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
  • Extreme sensitivity to the lightest touch — for some people even the weight of a sheet can be agonizing
  • Muscle weakness
  • Loss of reflex response
  • 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, urinary incontinence or urinary retention
  • Constipation, uncontrolled diarrhea or a combination of the two
  • Slow stomach emptying (gastroparesis) leading to nausea, vomiting, sensation of fullness and loss of appetite
  • Difficulty swallowing
  • Erectile dysfunction in men
  • Vaginal dryness and other sexual difficulties in women
  • Increased or decreased sweating
  • Sudden 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 even when you're at rest

Proximal neuropathy (diabetic polyradiculopathy)

Instead of affecting the ends of nerves in the feet, legs, hands and arms, like peripheral neuropathy, proximal neuropathy affects nerves in the thighs, hips, buttocks or legs. Also called diabetic amyotrophy, this condition is more common in people who have type 2 diabetes and in older adults.

Symptoms are usually on one side of the body, though in some cases symptoms may spread to the other side, too. Most people improve at least partially over six to 12 months. This condition is often marked by signs and symptoms including:

  • Sudden, severe pain in your hip and thigh or buttock
  • Weakness and shrinking of the thigh muscles
  • Difficulty rising from a sitting position

Mononeuropathy (focal neuropathy)

Mononeuropathy involves damage to a specific nerve. The nerve may be in the face, torso or leg. Mononeuropathy, which may also be called focal neuropathy, often comes on suddenly. It's most common in older adults.

Although mononeuropathy can cause severe pain, it usually doesn't cause any long-term problems. Symptoms usually lessen and disappear on their own over a few weeks or months. Signs and symptoms depend on which nerve is involved, and may 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
  • Pain in the front of your thigh
  • Chest or stomach pain

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

Signs and symptoms of carpal tunnel syndrome include:

  • Numbness or tingling in your fingers or hands, especially in your thumb, index finger, middle finger and ring finger
  • Loss of strength with a sense of weakness in your hand and a tendency to drop things

Be sure to talk with your doctor if you notice any of these symptoms. The sooner treatment begins, the better the chance of reducing complications.

May 20, 2020 See more In-depth

See also

  1. Abdominal pain
  2. Adult bed-wetting: A concern?
  3. Anhidrosis
  4. Anti-seizure medications
  5. Autonomic neuropathy
  6. Bell's palsy
  7. Bezoars: How do they happen?
  8. Bladder control: Lifestyle strategies
  9. Bladder control problems: Medications
  10. Bladder control problems in women: Seek treatment
  11. Carpal tunnel exercises: Can they relieve symptoms?
  12. Carpal tunnel syndrome
  13. Carpal Tunnel Tune-Up
  14. Chronic pain: Medication decisions
  15. Diabetic Gastroparesis
  16. Diabetic neuropathy
  17. Diabetic neuropathy and dietary supplements
  18. Diarrhea
  19. Erectile dysfunction dietary supplements
  20. Dizziness
  21. Ease the pain of diabetic neuropathy
  22. Electromyography (EMG)
  23. Erectile dysfunction
  24. Erectile dysfunction: Nonoral treatments
  25. Erectile dysfunction: A sign of heart disease?
  26. Erectile dysfunction and diabetes
  27. Erectile dysfunction treatment: How can your partner help?
  28. Erectile dysfunction medications
  29. Foot pain
  30. Gastroparesis
  31. 'Herbal viagra': Is it safe?
  32. Hyperglycemia in diabetes
  33. Hyperhidrosis
  34. Hypothyroidism: Can it cause peripheral neuropathy?
  35. Joint pain
  36. Joint pain: Rheumatoid arthritis or parvovirus?
  37. Managing diabetic neuropathy complications
  38. Nausea and vomiting
  39. Nerve conduction studies
  40. Numbness
  41. Numbness in hands
  42. Orthostatic hypotension (postural hypotension)
  43. Peripheral neuropathy
  44. Recreational ED drug use
  45. Sexual dysfunction
  46. Unexplained weight loss
  47. Urinary incontinence
  48. Urinary incontinence surgery in women
  49. Urinary tract infection (UTI)
  50. Vaginal dryness after menopause: How to treat it?
  51. Carpal tunnel symptoms: Role of nonsurgical treatment
  52. Carpal tunnel syndrome surgery: Immediate and long-term results