Diabetic Neuropathy

Diabetic neuropathy is a complication of diabetes that gradually causes nerve damage due to prolonged high blood sugar levels. While there is no cure, managing blood sugar levels can help slow down its progression and prevent complications.

This condition is common in both type 1 and type 2 diabetes, and can take several decades to develop. Early symptoms of peripheral neuropathy may include numbness, tingling, pain, or weakness in the hands or feet, which require medical attention to prevent the development of ulcers or other complications.

If peripheral neuropathy becomes severe or prolonged, you may be at risk of injuries or infections, which may lead to poor wound healing or even amputation. Different types of diabetic neuropathy affect various parts of the body, each with its specific symptoms.

Therefore, if you have diabetes, it’s essential to regularly check your blood glucose levels and contact your doctor if you experience any symptoms of neuropathy to prevent complications.

What are the symptoms of diabetic neuropathy?

The symptoms of diabetic neuropathy typically appear gradually over time. Often, the first sign of nerve damage is in the feet, causing a painful sensation of “pins and needles.”

Symptoms can vary depending on which parts of the body are affected, and there are several different types of diabetic neuropathy. Common symptoms associated with each type of neuropathy include:

  • Loss of sense of touch or increased sensitivity to touch
  • Difficulty walking or coordination problems
  • Numbness or pain in the hands or feet
  • Burning sensation in the feet, especially at night
  • Muscle weakness or wasting
  • Bloating, fullness, nausea, indigestion, vomiting, diarrhea, or constipation
  • Dizziness when standing up
  • Excessive or decreased sweating
  • Bladder problems, such as difficulty emptying the bladder completely
  • Vaginal dryness or erectile dysfunction
  • Inability to sense low blood glucose
  • Vision problems, including double vision
  • Increased heart rate

If you experience any of these symptoms and have diabetes, it’s important to speak with your healthcare provider as soon as possible to address the issue and prevent further complications.

Types of diabetic neuropathy

In individuals with diabetes, neuropathy is a term used to describe multiple types of nerve damage. There are four primary types of neuropathy that affect people with diabetes:

  1. Peripheral Neuropathy: Peripheral neuropathy is the most common form of neuropathy that typically affects the legs and feet, but it can also affect the arms and hands. The symptoms vary in severity from mild to severe and include numbness, tingling or burning sensations, sensitivity to touch, insensitivity to hot and cold temperatures, sharp pain or cramping, muscle weakness, loss of balance or coordination, and nighttime symptoms. People with peripheral neuropathy may not feel injuries or sores on their feet due to poor circulation, increasing the risk of infection, and possibly leading to amputation.
  2. Autonomic Neuropathy: Autonomic neuropathy is the second most common type of neuropathy in people with diabetes. It affects the autonomic nervous system, which regulates various systems in the body, including digestion, sweat glands, sex organs and bladder, and the cardiovascular system. Digestion problems include constipation, diarrhea, swallowing difficulties, gastroparesis, and nausea/vomiting. Sexual problems may include erectile dysfunction, vaginal dryness, or difficulty achieving orgasm, and neuropathy in the bladder can cause incontinence or make it challenging to empty your bladder. Autonomic neuropathy can also cause cardiovascular problems such as a drop in blood pressure, dizziness, and an abnormally fast heart rate.
  3. Proximal Neuropathy: Proximal neuropathy, also known as diabetic amyotrophy, is a rare form of neuropathy that typically affects adults over 50 years old with type 2 diabetes and is more common in men. It affects the hips, buttocks, or thighs, and sudden, severe pain may occur. Muscle weakness in the legs may make it difficult to stand up without assistance, and it typically affects only one side of the body. Symptoms usually get worse initially and then slowly improve over time, with most people recovering within a few years, even without treatment.
  4. Focal Neuropathy: Focal neuropathy, also called mononeuropathy, occurs when there is damage to one specific nerve or group of nerves, causing weakness in the affected area. This usually happens in your hand, head, torso, or leg and appears suddenly, with intense pain being a common symptom. Most focal neuropathies go away in a few weeks or months without causing lasting damage. Carpal tunnel syndrome is the most common type of focal neuropathy, and about 25% of people with diabetes have some degree of nerve compression at the wrist. Symptoms of focal neuropathy may include pain, numbness, tingling in fingers, inability to focus, double vision, aching behind the eyes, Bell’s palsy, pain in isolated areas such as the front of the thigh, lower back, pelvic region, chest, stomach, inside the foot, outside the lower leg, or weakness in the big toe.