Symptoms of Diabetic Neuropathy

Diabetic neuropathy is nerve damage that can cause unpleasant sensations, diminished sensation, weakness, diarrhea, constipation, and difficulty with urination. It can also cause serious health issues, like cardiovascular problems. And the loss of sensation and weakness can lead to injuries and infections.

If you have diabetes, it’s important to be aware of the potential effects, including diabetic neuropathy, so you can recognize and avoid the harmful health consequences. This article will discuss the symptoms and complications of diabetic neuropathy.

Frequent Symptoms 

Sensory symptoms (what you sense or feel) and autonomic symptoms (related to nonvoluntary body functions) are the earliest symptoms of diabetic neuropathy. Motor effects (involving movement) can occur as well, particularly as the condition advances. 

Common symptoms of diabetic neuropathy include:

• Numbness and tingling of the hands or feet 
• Pain and burning sensations of the feet or hands, even without anything touching your skin 
• Hypersensitivity of the skin—things that should not hurt may cause pain
• Diminished sensation of the hands or feet 
• Decreased fine motor control (coordination for small, exact movements)
• Balance problems when walking 
• Trouble emptying the bladder or bladder incontinence (inability to control the release of urine)
• Abdominal discomfort 
• Diarrhea and constipation 
• Diminished sexual function 

Any of these symptoms can occur in the early stages of diabetic neuropathy and may even affect people with long-term diabetes who have had good blood sugar control. 

Rare Symptoms 

The same type of nerve damage that causes the common effects of diabetic neuropathy can also extend to cause more severe nerve damage and may cause damage to nerves throughout the body.

Less common or late effects of diabetic neuropathy can include:

• Hypotension (low blood pressure), which may cause light-headedness
• Postural hypotension (low blood pressure when going from a sitting or lying to a standing position) 
• Pain, burning, or loss of sensation in proximal (close to the body) areas—the arms, legs, face, or trunk 
• Substantial weakness of hands, feet, or other areas of the body 
• Facial weakness 
• Fecal incontinence (loss of control of defecation)
• Trouble swallowing
• Irregular heart rate 

These symptoms are not usually early effects of diabetic neuropathy. Many people with diabetes never experience the less common effects of diabetic neuropathy. 

Complications

Diabetic neuropathy can lead to a variety of serious health problems for some people. And the combination of diabetic neuropathy with other effects of diabetes can predispose you to certain complications, such as infections and problems with wound healing. 

Complications of diabetic neuropathy may include:

• Injuries to the extremities can occur due to lack of sensation and diminished motor control.
• A risk of falling can occur due to hypotension and decreased coordination.
• Infection or ulceration of injuries to the extremities can occur and worsen due to lack of sensation and lack of awareness of the injury.
• Diarrhea may cause weight loss and malnutrition.
• Severe gastrointestinal slowing can lead to a bowel obstruction.
• Urinary retention (inability to empty the bladder) can lead to bladder infections. 

General muscle weakness can also contribute to inactivity, with potentially harmful consequences, such as weight gain, hypertension (high blood pressure), and unhealthy cholesterol levels. 

When to See a Healthcare Provider/Go to the Hospital

Be sure to keep up with regularly scheduled visits with a healthcare provider to ensure that any complications are caught and treated early. This can also prevent complications from getting worse. If you develop signs of diabetic neuropathy, make an appointment to see a healthcare provider. 

Call a healthcare provider if you have the following:

• New or worsening numbness, burning, or pain in your hands, feet, or other areas of your body 
• Feeling cold or hot in your feet or hands 
• Urinary urgency, frequency, or bladder incontinence
• Foul-smelling urine
• A fever 
• Diarrhea, constipation, or bowel incontinence 
• Change in sexual function 
• Weakness of your hands, feet, arms, legs, or face 
• Difficulty chewing or swallowing, or choking while you are trying to eat 
• A wound that you can’t feel 
• A stable wound or bruise that isn’t healing normally 
• Feeling dizzy, light-headed, or faint

Some of these symptoms may progressively worsen over time with diabetic neuropathy. It’s helpful to have a plan for checking in with a healthcare provider to work together to monitor changes and decide whether you need an adjustment in your treatment plan. 

Get prompt medical attention if you develop:

• A wound that’s painful, pus-filled, bleeding, or has a bad odor
• Black, blue, or red discoloration of your hands or feet 
• Swelling of your hands or feet 
• A severe injury or broken bone, whether it is painful or not 
• Inability to empty your bladder or have a bowel movement 

Summary 

Diabetic neuropathy causes a variety of sensory, motor, and autonomic symptoms. The sensory effects cause both unpleasant sensations and diminished sensations. Some effects of diabetic neuropathy are serious, including the risk of falling, injuries, infections, and hypotension.

If you have diabetes or have begun to experience diabetic neuropathy symptoms, it’s important to check for cuts and bruises regularly and to keep an eye on any wounds as they heal. 

A Word From Verywell 

Living with diabetes means being vigilant about taking care of your health every day. You can take steps to check for any harmful effects of diabetic neuropathy regularly. Get medical attention as soon as you begin to develop any signs of complications.