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Health A-Z

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Harvard Medical School

Symptoms

Most people who have had diabetes for 25 years have some form of neuropathy. Symptoms depend on the specific type of neuropathy.

  • 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

    • Hypersensitivity to touch

    • Problems in balance or coordination

If your feet are numb, you may not be aware when shoes don't fit properly. This can lead to the formation of a callus.

These thickened skin areas can break down over time. They can change into an open sore (ulcer) that may become infected.

  • Autonomic neuropathy. The symptoms of autonomic neuropathy vary. They depend on which of your automatic body functions have lost their normal nerve control. Any of the following problems can occur:

    • Incomplete bladder emptying. This can cause you to urinate more often. Urinary infections can be a problem. So can loss of bladder control.

    • Sexual function problems. Problems with erection, ejaculation and sexual drive are common.

    • Stomach and bowel problems. Slow emptying of the stomach can cause nausea, vomiting or bloating. The normal rhythmic squeezing of the small and large intestines can be slow or irregular, causing constipation or diarrhea. Swallowing may become difficult. Loss of control over bowel movements is possible.

    • Dizziness when standing. Normally, your heart gears up to pump a little faster and harder when you are standing up. 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, causing your low blood pressure to drop when you stand up. This is called orthostatic hypotension. The main symptom is lightheadedness with standing. You could faint if you did not sit or lie down when lightheadedness occurs.

  • Focal neuropathy. The symptoms will vary, depending upon which nerve is affected. For example, you would have:

    • Double vision -- if it is one of the nerves that controls movements of muscles attached to the eye

    • Drooping of a cheek and inability to close an eye on the same side of the face (Bell's palsy) -- if it is the facial nerve (cranial nerve number seven)

    • Sudden weakness in the ankle (foot drop) -- if it is the peroneal nerve (a branch of the sciatic nerve that controls foot movement).

  • Radiculopathy. Damage to a nerve that begins in the spinal cord and tracks out between the vertebrae (the bones that surround and protect the spinal cord) is called radiculopathy. It can cause pain in any part of the body. When the damaged nerve is one that goes to an arm or leg, it can cause muscle weakness in the affected extremity.

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From Health A-Z, Harvard Health Publications. Copyright 2007 by the President and Fellows of Harvard College. All rights reserved. Written permission is required to reproduce, in any manner, in whole or in part, the material contained herein. To make a reprint request, contact Harvard Health Publications. Used with permission of StayWell.

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