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Signs and Symptoms of Diabetic Neuropathy

Neuropathy, or nerve damage, is a common long-term complication of diabetes that usually affects the hands and feet. The Neuropathy Association, Inc. estimates that more than 20 million Americans suffer from this condition. By learning to recognize the warning signs, diabetics can protect themselves from the effects of this disorder.

  1. Foot and Leg Problems

    • When blood sugar is high, damage to the nerves and blood vessels that supply the legs and feet may cause loss of sensation. Without feeling in the feet, the pain associated with foot injuries can go undetected. The nerve damage itself can cause the feet to change shape, increasing the risk of problems resulting from improper fitting shoes. Because high blood sugar levels and poor circulation (common in diabetes) slow down the healing process, diabetic foot problems can quickly become serious. Peripheral vascular disease is a condition caused by atherosclerotic plaque buildup within the blood vessels, which over time decreases blood flow to the lower legs and feet. Leg and foot symptoms of diabetic neuropathy include loss of sensation in the legs and feet, leg pain caused by exercising that improves upon resting, pain in the legs and feet at night and chronically cold feet. The skin of the lower legs may appear shiny and hairless. Bruises, sores and hot, swollen tender spots on the feet may also develop.

    Signs of Autonomic Neuropathy

    • Damage to the autonomic nervous system (which controls involuntary actions such as breathing and digestion) is known as autonomic neuropathy. Symptoms may include sexual dysfunction, dizzy spells, heartburn and other gastrointestinal disorders. People suffering from autonomic neuropathy may not be able to detect when the bladder is full and may not be able to empty the bladder completely. Urinary tract infections may occur frequently due to urine retention. Upper gastrointestinal symptoms related to autonomic neuropathy include feelings of fullness in the stomach soon after eating, hypoglycemic episodes after eating, heartburn, abdominal pain and bloating, reflux, vomiting of undigested food and anorexia. Lower gastrointestinal problems vary, from constipation to diarrhea.

    Cardiovascular Problems

    • Diabetics with autonomic neuropathy may have a fixed heart rate, which means that the body does not adjust properly to increased physical activity level, or they may develop orthostatic hypotension, which causes a drop in blood pressure when standing up from a lying down position. One might feel dizzy, lightheaded, weak or have vision changes upon rising.

    Other Signs and Symptoms

    • Diabetic neuropathy can impair the body's ability to sweat, increasing the risk of heat stroke and foot problems due to dry feet. The nerves of the pupils in the eyes may have difficulty adjusting to darkness. Skin problems are more common and may cause symptoms such as sores that do not heal. Redness, swelling, pus, heat and pain can be signs of infection.

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