Symptoms
More than half of all people with diabetes have developed some form of neuropathy by the time they have had diabetes for 25 years. Symptoms depend on the specific type of neuropathy.
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Peripheral neuropathy - This form of neuropathy causes symptoms in the limbs, especially the lower legs and feet. Symptoms can include numbness, tingling, sharp or burning pain, cramps, hypersensitivity to touch, and problems in balance or coordination. If your feet are numb, you may not be aware when shoes don't fit properly, and this can lead to the formation of a callus. Calluses are serious problems for people with diabetes, because these thickened skin areas can break down over time and change into an open sore (ulcer) that may become infected.
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Autonomic neuropathy - The symptoms of autonomic neuropathy are varied, depending on which of your automatic body functions have lost their normal nerve control. Any of the following problems can occur:
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Incomplete bladder emptying - This can cause you to urinate more often, including at night. Urinary infections can be a problem, and so can loss of bladder control.
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Sexual function problems - Problems with erection, ejaculation and libido (sexual drive) are common.
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Stomach and bowel problems - Slow emptying of the stomach, called gastroparesis, can cause nausea, vomiting or bloating. The normal rhythmic squeezing of the small and large intestines that is known as peristalsis can be slow or irregular, causing constipation or diarrhea. Swallowing may become difficult, and loss of control over bowel movements is possible.
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Dizziness when standing - Normally, your heart gears up to pump a little faster and harder when you are standing up, because it is pumping against gravity to move blood from your toes to your torso. Arteries help to keep your blood pressure steady by adjusting the squeeze of their muscular walls. Both your heart and arteries rely on nerve signals to know when to make these adjustments. These signals can fail in diabetes, leaving you with low blood pressure when you are standing. Low blood pressure that occurs when standing is also called orthostatic hypotension and is a common cause of lightheadedness or fainting in people with diabetes.
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Changes in the amount that you sweat - An inability to sweat can lead to dry and cracking feet, which can allow fungal infections to develop more often. Excessive sweating or bursts of sweating also can occur.
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Focal neuropathy - Common symptoms are double vision, drooping of the cheek on one side of the head (commonly known as Bell's palsy), problems with speech and double vision. Focal neuropathy also can cause a sudden weakness in the ankle, called foot drop. Damage to a nerve that originates in the spinal cord is called radiculopathy, which can cause pain in the chest, stomach, back or pelvis or in the front of the thigh.
