Symptoms

There are 4 types of diabetic neuropathy. You may have a solitary symptom or a combination of these.

Peripheral neuropathy

• This effects feet and legs before hands and arms.
• The symptoms are worse at night and include:
• Numbness or reduced ability to feel pain and temperature.
• Tingling or burning sensation
• Sharp pain or cramps
• Increased sensitivity to touch – weight of bed sheet can be agonizing.
• Muscle weakness
• Loss of ankle reflexes
• Loss of balance and coordination
• serious foot problems like ulcers, infections and deformities, bone and joint pain.

Autonomic neuropathy

The autonomic nerves control the heart, bladder, lungs, intestines, stomach, sex organs and eyes. They may cause:

• Lack of awareness that the blood sugar levels are low (hypoglycemia awareness)
• Bladder problems like urinary tract infection, urinary retention or incontinence.
• Constipation, uncontrolled diarrhoea or a combination of both
• Slow stomach emptying (gastroparesis)  causing nausea, vomiting, and loss of appetite.
• Difficulty swallowing
• Erectile dysfunction in men.
• Vaginal dryness and other difficulties in females
• Increased or decreased sweating
• Inability to adjust to blood pressure and heart rate with a sharp drop in blood pressure on standing or sitting that may cause you to faint and feel light headed
• Problems regulating your body temperature
• Changes in the way your eyes adjust from light to dark
• Increased heart rate when you are at rest.

Rediculoplexus Neuropathy (diabetic amyotrophy)

• Affects nerves in the thigh, hips, buttock and the legs.
• It is commoner in people with type 2 diabetes and older people.
• Mostly it is unilateral though it may be bilateral.
• The symptoms are:
• Sudden severe pain in hip, buttock or thigh
• Eventual weak and atrophic thigh muscles
• Difficult to rise from a sitting position
• Abdominal swelling if the abdomen is affected
• weight loss

Mononeuropathy

• It is damage to specific nerves
• Is sudden in onset and affects elderly males
• It may cause severe pain but disappears over a few weeks.
• Symptoms depend on which nerve is affected:
• Difficulty in focusing eyes, double vision or aching behind eyes
• Paralysis on one side of the face (Bell’s palsy)
• Pain on shin or foot
• Pain lower back or pelvis
• Pain in front of the thigh
• Pain in the chest or abdomen
• It may occur when the nerve is compressed as in carpal tunnel syndrome. The symptoms include:
• Numbness or tingling in your fingers and hand especially the thumb, index, middle and ring fingers.
• A sense of weakness in your hand and tendency to drop things

When to see your doctor

• See your doctor if there is a sore on your foot which is not healing, getting infected or worse.
• Burning, tingling, weakness or pain in hands or feet that interferes with your daily routine or sleep.
• Dizziness
• Changes in your urination, digestion or sexual function

These symptoms are not always due to nerve damage but signal other problems needing medical care. Early diagnosis and treatment offer the best chance for controlling symptoms and preventing more severe problems.

Minor sores if neglected can lead to ulcers which if not treated may become infected or gangrenous needing surgery or amputation. Early treatment can prevent this from happening.