Diabetic neuropathy is a type of nerve damage that can occur if you have diabetes. High blood sugar may damage nerve fibers in your body, but diabetic neuropathy most often injures nerves in your legs and feet.

Depending on the affected nerves, symptoms of diabetic neuropathy can range from pain and numbness in your extremities to problems with your digestive system, urinary tract, blood vessels and heart. Symptoms range from mild, painful, disabling and even fatal.

Diabetic neuropathy is a common complication of diabetes. Yet you can prevent diabetic neuropathy or slow its impetus with rigorous blood sugar control and a healthy lifestyle.

There are four main types of diabetic nerve pain. Most develop gradually, and you may not notice problems until considerable damage has occurred. The signs and symptoms of diabetic neuropathy will vary, the type of neuropathy and the specific nerves affected will account for a range of severity of symptoms.

Peripheral neuropathy

Peripheral neuropathy is the most common form of diabetic neuropathy. It starts in the legs and feet followed by your hands and arms. Possible signs and symptoms of peripheral neuropathy include:

  • Numbness from pain and temperature, especially in your feet and toes
  • A tingling or burning feeling
  • Sharp, jabbing pain that may be worse during the night
  • Agony when walking
  • Extreme sensitivity to the lightest touch — for some people, even the weight of a bed sheet can be very painful.
  • Muscle fatigue and trouble with walking
  • Severe foot problems, such as ulcers, infections, deformities, bone and joint hurt

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:

  • Ignorance that blood sugar levels are low (hypoglycemia unawareness)
  • 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
  • Your body to cannot adjust blood pressure and heart rate causing sharp falls in blood pressure when you rise from sitting or lying down (orthostatic hypotension) this may cause you to feel vertigo or faint
  • You experience difficulty regulating your body temperature to a normal. 
  • Problems with your eyes adjusting from light to dark
  • Rapid heart rate at rest. 

Radiculoplexus neuropathy (diabetic amyotrophy)

Instead of affecting the ends of nerves, like peripheral neuropathy, radiculoplexus neuropathy affects nerves in the thighs, hips, buttocks or legs. Also called diabetic amyotrophy, femoral neuropathy, or proximal neuropathy, this condition is more common in people with type 2 diabetes and older adults. One side of the body usually feels the symptoms but they can be felt on both sides. Most people improve at least partially in time, though symptoms may worsen before they get better. You can identify this condition as follows:

  • Sudden, intense pain in your hip and thigh or buttock
  • Weak then atrophied thigh muscles
  • Difficulty sitting up
  • Abdominal swelling, if the abdomen is affected
  • Loss of weight 

Mononeuropathy

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 incense pain, it usually doesn’t cause any long-term damage. Fortunately symptoms often go away 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:

  • Loss of feeling or tingling in your fingers or hand, especially in your thumb, index finger, middle finger and ring finger
  • A real of weakness in your hand and a tendency to drop things