Diabetic Neuropathy Symptoms
This form of diabetic neuropathy damages nerves in the arms and legs. The feet and legs are likely to be affected before the hands and arms. Many people with diabetes have signs of neuropathy upon examination but have no symptoms of diabetic neuropathy at all. Peripheral neuropathy symptoms may include:
- Numbness or insensitivity to pain or temperature
- A tingling, burning, or prickling sensation
- Sharp pains or cramps
- Extreme sensitivity to touch, even a light touch
- Loss of balance and coordination.
These symptoms are often worse at night.
Peripheral neuropathy may also cause muscle weakness and loss of reflexes, especially at the ankle, leading to changes in gait (walking). Foot deformities -- such as hammertoes and the collapse of the midfoot -- may occur. Blisters and sores may appear on numb areas of the foot because pressure or injury goes unnoticed.
If foot injuries are not treated promptly, the infection may spread to the bone, and the foot may then have to be amputated. Some experts estimate that half of all such amputations are preventable if minor problems are caught and treated in time.
Autonomic neuropathy affects the nerves that control the:
- Heart and circulatory system
- Digestive system
- Urinary tract
- Sex organs
- Sweat glands
In addition, the system that restores blood glucose levels to normal after a hypoglycemic episode may be affected, resulting in loss of the warning signs of hypoglycemia (such as sweating and palpitations).
Unawareness of Hypoglycemia
Normally, symptoms such as shakiness occur as blood glucose levels drop below 70 mg/dL. In people with autonomic neuropathy, however, these symptoms may not occur, making hypoglycemia difficult to recognize.
Other problems can also cause hypoglycemia unawareness, so this does not always indicate nerve damage.