Diabetic Neuropathy: Types, Causes, and Symptoms


Diabetic Neuropathy: Types, Causes, and Symptoms

If you’re one of 29 million people living with diabetes, you’re at risk of diabetic neuropathy, a condition caused by diabetes. Diabetic neuropathy occurs for several reasons that are all related to the long-term damage caused by extended periods of high blood sugar.

Before going into the specific causes and implications of diabetic neuropathy, it’s important to first have a top-level understanding of diabetes and its effects on the body.


Diabetes, in short, is the inability to manage changing levels of blood glucose, or blood sugar levels in the body. Problems arise when the body has trouble maintaining the balance of blood glucose levels, and must be treated.

Type 1 Diabetes: The pancreas, the organ responsible for producing insulin, has difficulty producing enough insulin for the body due to damaged cells in the pancreas. Insulin is necessary for blood sugar regulation, and without it, blood sugar spikes occur causing unstable and damaging conditions in the body.

Type 2 Diabetes: The pancreas produces enough insulin, but the cells reject the insulin. When this happens, the body creates an overproduction of insulin, and eventually, the pancreas ends up overworked and damaged.

For more on Diabetes and blood sugar monitoring, read our previous blog, Blood Glucose Monitoring: Why and How?

Diabetic Neuropathy

With diabetes, the body has difficulty recovering from high blood sugar spikes (after a meal, drink, or sugary snack), leading to extended periods of high blood sugar in the bloodstream. Over time, these high levels of blood sugar can damage nerves in the body. This nerve damage caused by diabetes is called diabetic neuropathy.  There are four main types of diabetic neuropathy, and the signs and symptoms vary for each one. Many people experience anywhere from one to many symptoms, and sometimes don’t have noticeable problems until substantial damage has occurred.

Peripheral Neuropathy

As the most common form of diabetic neuropathy, peripheral neuropathy often affects the legs and feet first, then moves to the arms and hands. Often, these symptoms are most painful at night.

Symptoms of peripheral neuropathy include:

  • Numbness or inability to discern temperature.
  • Tingling, burning, or sharp pain or cramps (especially at night).
  • Increased (sometimes alarming) sensitivity to touch.
  • Weakness, loss of balance and coordination.
  • Lowered reflexes.
  • Ulcers, infections, deformities, and bone and joint pain in the feet.

You can monitor these symptoms by:

  • Checking your feet and legs daily.
  • Moisturizing your feet.
  • Maintaining your toenail hygiene.
  • Wearing comfortable shoes to prevent foot injury.

In severe cases, if left untreated, even minor cuts on feet can turn into ulcers and sometimes lead to gangrenous tissue, requiring surgery or amputation. Don’t let these symptoms go untreated.

Autonomic Neuropathy

This type of diabetic neuropathy typically upsets the digestive system. Autonomic refers to the autonomic nervous system, a system of the body that comprises the heart, bladder, lungs, stomach, intestines, sex organs, and eyes. Because of this, signs of autonomic neuropathy may be evident in any of these organs. This type of neuropathy is often noticed due to changes to the blood vessels, urinary system, and sex organs.

Symptoms of autonomic neuropathy include:

  • Bloating, nausea, vomiting, loss of appetite.
  • Diarrhea, constipation, or a combination of both.
  • Heartburn and heightened heart rate.
  • Vaginal dryness, reduced ejaculations, and erectile dysfunction.
  • Inability to adjust blood pressure and heart rate after sitting or standing.
  • An unexplainable feeling of being cold or hot.
  • Feeling full after a small meal.
  • Unawareness of low blood sugar levels (hypoglycemia).

Symptoms can often be helped by making changes to your lifestyle: including the use of special stockings, changes to your diet, counseling, surgery, or medication prescribed by a physician.

Radiculoplexux/Proximal Neuropathy (Also called, Diabetic Amyotrophy)

This condition is a less common form of diabetic neuropathy, and most commonly occurs in older people, and people living with type 2 diabetes. It typically affects nerves in the thighs, buttocks, hips, and legs, and often affects just one one side of the body.  This damage can lead to severe loss of muscle tone, and can be very painful. Symptoms of radioculoplexus neuropathy include:

  • Sudden or extreme pain in thighs, hips, and legs.
  • Weakened thigh muscles.
  • Difficulty standing from a seated position.
  • Swelling of the abdominals.
  • Weight loss.

You can monitor these symptoms by paying close attention to any changes in pain or weakness of one or both sides of the body on the thighs, legs, and hips. If you notice any changes, contact your physician.

Mononeuropathy/Focal Neuropathy

Mononeuropathy refers to damage to a specific nerve. Nerve damage may occur in a nerve located in the face, torso, or leg. This type of diabetic neuropathy most often occurs suddenly and is most often seen in older adults. Damage from Mononeuropathy is often not long-term, and symptoms usually disappear within a few months. Occasionally, a compressed nerve causes mononeuropathy. Symptoms of mononeuropathy vary, depending on the location of the damaged nerve, and may include:

  • Numbness, tingling, or weakness in the fingers and hand.
  • Affected vision – problems focusing, double vision, aching.
  • Facial paralysis.
  • Leg, shin, or foot pain.
  • Lower back, pelvic, or abdominal pain.

To manage symptoms, seek medical treatment if you experience symptoms of mononeuropathy, and tell your physician about all the symptoms you’re experiencing.  Unfortunately, Mononeuropathy is often painful and unpredictable; the good news is that it often goes away on its own over a relatively short amount of time, without leaving long-term damage.

If you are diabetic and notice any of these symptoms, consult your physician as soon as you can. Even if your physician concludes that your symptoms are not related to diabetic neuropathy, they may indicate other health issues. As with any medical concern, early detection can increase the chances of recovering, limiting pain and suffering, managing symptoms, and preventing long-term damage.

Diabeties at WWMG

At WWMG, our Endocrinology providers are dedicated to helping patients manage their diabetic symptoms, prevent diabetes progression, and maintain a high quality of life while living with diabetes. For more details about our diabetes services, please visit our Endocrinology page, and don’t hesitate to reach out if you have any questions.