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Everything You Need to Know About Diabetic Neuropathy

Dr. Eman Elmi
January 7, 2024
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Diabetic neuropathy affects as many as half of all people with diabetes. This nerve damage can affect different body parts, and symptoms can vary from mild to debilitatingly painful. This article will review everything you need to know about diabetic neuropathy, including symptoms and possible treatment methods.

Understanding Diabetic Neuropathy Symptoms

Diabetic neuropathy symptoms can vary in terms of intensity depending on the affected nerves. Symptoms usually develop gradually, and they might not be noticeable until considerable nerve damage has already occurred. Moreover, people can be affected by more than one type of diabetic neuropathy at a time.

The exact cause of each type of neuropathy is unknown. However, it’s believed that, over time, uncontrolled high blood sugar damages nerves and interferes with their ability to transmit signals. High blood sugar also weakens the walls of the capillaries that supply the nerves with oxygen and nutrients.

That said, let’s take a closer look at different types of diabetic neuropathy.

Peripheral Neuropathy

Also called distal symmetric peripheral neuropathy, it’s the most common type of diabetic neuropathy. Peripheral neuropathy first affects the feet and legs, followed by the hands and arms.

Symptoms can include numbness and reduced ability to feel pain or temperature changes. They can also include tingling or burning, sharp cramps, muscle weakness, and extreme touch sensitivity. 

Also, peripheral neuropathy is linked to serious foot problems like ulcers, infections, and bone and joint damage. These symptoms can increase in intensity at night.

Autonomic Neuropathy

The autonomic nervous system (ANS) controls many systems throughout the body. These include blood pressure, heart rate, sweating, eye movement, bladder activity, the digestive system, and sex organs. Diabetic nerve damage can affect nerves in the ANS, creating potential problems in many of them.

Symptoms of diabetic neuropathy affecting the ANS can include a lack of awareness of blood sugar levels (also called hypoglycemia awareness), dizziness, and fainting. This can occur through sudden drops in blood pressure when rising from sitting or lying down. Moreover, this nerve damage can cause bladder or bowel problems, difficulty swallowing, or increased or decreased sweating.

Slow stomach emptying (also called gastroparesis) can also be linked to neuropathic damage. This can cause vomiting, nausea, loss of appetite, or sensations of fullness. The nerve damage can cause changes in the way eyes adjust from light to dark or near to far. It can also cause problems in sexual response, such as vaginal dryness in women and erectile dysfunction in men.

Proximal Neuropathy

Also known as diabetic polyradiculopathy, this type of neuropathy affects nerves in the thighs, hips, buttocks, or legs. Damage to these nerves can also affect the abdomen or chest area. Symptoms usually occur on one side of the body but can spread to the other side as well.

Symptoms include severe pain in the buttock and hip or weakening or shrinking thigh muscles. This can cause difficulty rising from a sitting position or chest or abdominal wall pain.


Also called focal neuropathy, the damage from mononeuropathy affects a single specific nerve. This nerve can be in the face, torso, arm, or leg. Since symptoms cover such a wide area, symptoms are similarly wide-ranging.

In mononeuropathy affecting facial nerves, patients may have difficulty focusing or double vision. They can also feel paralysis on one side of the face. Damage to arm nerves can lead to numbness or tingling in the hands or fingers or weakness, leading to dropped objects. Contrarily, damage to leg nerves can similarly cause localized pain in the shin, foot, or thigh.

It’s worth repeating that these types of diabetic neuropathy can occur simultaneously to each other. So you may, for example, feel symptoms related to two or more types because of differently affected nerves.

Breaking Down Diabetic Neuropathy Treatment

Diabetic neuropathy treatment should begin with a diagnosis from your medical provider. Call them for an appointment if you experience any of the following symptoms, especially if you were previously diagnosed with diabetes.

  • Cuts or sores on the feet that are infected and won’t heal.
  • Burning, tingling, weakness, or pain in the hands or feet that interfere with sleep or activity.
  • Changes in digestion, urination, or sexual function.
  • Unexplained dizziness or fainting.

The American Diabetes Association (ADA) recommends screening for diabetic neuropathy immediately after a type 2 diabetes diagnosis. In cases of type 1 diabetes, screening should occur within five years after diagnosis. After that, screening is recommended once a year.

Additionally, diabetic neuropathy and related complications can be delayed by closely managing blood sugar. People living with diabetes should have their glycated hemoglobic (A1C) tested at least twice a year. 

While exact figures vary, the ADA generally recommends an A1C level of less than 7.0%. Higher blood sugar levels may require adjustments in lifestyle or daily management to reduce the risk of neuropathy.

Diablo Foot and Ankle is Here to Help

Now you know everything you need to know about diabetic neuropathy, you know how important it is to seek treatment. If you live in the Walnut Creek area and may be affected by diabetic neuropathy, Diablo Foot and Ankle can help. 

Foot ulcerations and nerve damage are some of the most common symptoms associated with diabetic neuropathy. In especially severe and advanced cases, it can even lead to amputation. Request a consultation today or schedule an appointment for more information.

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