Retinopathy, neuropathy, and foot care: standards of medical care in diabetes Accessed December 8, Brownlee M, Aiello LP, Sun JK, et al. Complications of diabetes mellitus. In: Melmed S, Auchus, RJ, Goldfine AB, Koenig RJ, Rosen CJ, eds. Williams Textbook of Endocrinology. Philadelphia, PA: Elsevier; chap Reviewed by: Sandeep K.

Dhaliwal, MD, board-certified in Diabetes, Endocrinology, and Metabolism, Springfield, VA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A. Editorial team. Share Facebook Twitter Linkedin Email Home Health Library.

Nerve damage from diabetes - self-care Diabetic neuropathy - self-care. Symptoms Tingling or burning in the feet and legs may be an early sign of nerve damage in them. Nerve damage may cause you to lose feeling in your feet and legs. Because of this, you may: Not notice when you step on something sharp Not know you have a blister or small wound on your toes Not notice when you touch something too hot or too cold Be more likely to bump your toes or feet against objects Have the joints in your feet to become damaged which can make it harder to walk Experience changes in the muscles in your feet which can cause increased pressure on your toes and balls of your feet Be more likely to have infections of the skin on your feet and in your toenails People with diabetes may have problems digesting food.

Symptoms of this problem are: Feeling full after eating only a small amount of food Heartburn and bloating Nausea, constipation, or diarrhea Swallowing problems Throwing up undigested food several hours after a meal Heart-related problems may include: Lightheadedness, or even fainting, when sitting or standing up Rapid heart rate Neuropathy may "hide" angina.

They are: Sudden fatigue Sweating Shortness of breath Nausea and vomiting Other symptoms of nerve damage are: Sexual problems. Men may have problems with erections. Women may have trouble with vaginal dryness or orgasm.

They are heterogeneous, with diverse clinical manifestations, and may be focal or diffuse. The fructosamine test is a measurement of glycated protein which is formed by a nonenzymatic reaction of serum proteins with glucose.

However, glycated album. Read more on Pathology Tests Explained website. When prescribing pain relief for older patients it is important to remember that ageing can affect the pharmacokinetics of analgesic drugs. Read more on Australian Prescriber website. Healthdirect Australia is not responsible for the content and advertising on the external website you are now entering.

Healthdirect Australia acknowledges the Traditional Owners of Country throughout Australia and their continuing connection to land, sea and community.

We pay our respects to the Traditional Owners and to Elders both past and present. We currently support Microsoft Edge, Chrome, Firefox and Safari. For more information, please visit the links below:. You are welcome to continue browsing this site with this browser.

Some features, tools or interaction may not work correctly. There is a total of 5 error s on this form, details are below.

Please enter your name Please enter your email Your email is invalid. Please check and try again Please enter recipient's email Recipient's email is invalid. Please check and try again Agree to Terms required.

Thank you for sharing our content. A message has been sent to your recipient's email address with a link to the content webpage. Your name: is required Error: This is required. Your email: is required Error: This is required Error: Not a valid value. Send to: is required Error: This is required Error: Not a valid value.

Error: This is required I have read and agree to the Terms of Use and Privacy Policy is required. On this page What is diabetic neuropathy? What are the symptoms of diabetic neuropathy? What causes diabetic neuropathy? When should I see my doctor? How is diabetic neuropathy diagnosed? How is diabetic neuropathy treated?

Can diabetic neuropathy be prevented? Complications of diabetic neuropathy Resources and support Related information on Australian websites What is diabetic neuropathy? It can also affect other nerves in your body known as the autonomic nerves and motor nerves.

Autonomic nerves carry signals to help with balance, sweating, digestion and many of the things you do without thinking. Motor nerves carry signals to help you move.

Symptoms usually lessen and disappear on their own over a few weeks or months. Symptoms depend on which nerve is involved, and may include:. Sometimes mononeuropathy occurs when a nerve is compressed.

Carpal tunnel syndrome is a common type of compression neuropathy in people with diabetes. Be sure to talk with your health care provider if you notice any of these symptoms.

The sooner treatment begins, the better the chance of reducing complications. There is a problem with information submitted for this request. Sign up for free and stay up to date on research advancements, health tips, current health topics, and expertise on managing health.

Click here for an email preview. Error Email field is required. Error Include a valid email address. To provide you with the most relevant and helpful information, and understand which information is beneficial, we may combine your email and website usage information with other information we have about you.

If you are a Mayo Clinic patient, this could include protected health information. If we combine this information with your protected health information, we will treat all of that information as protected health information and will only use or disclose that information as set forth in our notice of privacy practices.

You may opt-out of email communications at any time by clicking on the unsubscribe link in the e-mail. You'll soon start receiving the latest Mayo Clinic health information you requested in your inbox.

Mayo Clinic does not endorse companies or products. Advertising revenue supports our not-for-profit mission. Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press. This content does not have an English version. This content does not have an Arabic version.

Appointments at Mayo Clinic Mayo Clinic offers appointments in Arizona, Florida and Minnesota and at Mayo Clinic Health System locations. Request Appointment.

Diabetic neuropathy types: Symptoms tell the story. Products and services. Diabetic neuropathy types: Symptoms tell the story By Mayo Clinic Staff. Thank you for subscribing! Sorry something went wrong with your subscription Please, try again in a couple of minutes Retry.

Show references Nerve damage Diabetic neuropathies. National Institute of Diabetes and Digestive and Kidney Diseases. Accessed March 25, Jameson JL, et al. Diabetes mellitus: Complications. In: Harrison's Principles of Internal Medicine. The McGraw-Hill Companies; Melmed S, et al.

These symptoms can significantly affect your quality of life. There are many forms of neuropathy, depending on which part of your body is affected. Autonomic neuropathy results from damage to nerves that control automatic body functions, including digestion, bladder and sexual function, blood pressure, and body temperature.

Damage to a single nerve is called mononeuropathy, and damage to multiple nerves is called polyneuropathy.

Peripheral neuropathy affects the limbs, often feet, legs , hands and arms. This is the type that causes leg pain.

Nerve damage that results in weakness in the hips, thighs and shoulders is called proximal neuropathy; this is more rare than peripheral neuropathy. Living with leg pain and other diabetes-related conditions can be difficult.

Certified diabetes care and education specialists at Norton Healthcare can help by providing education about diabetes care, medications, and nutrition. These diabetes educators are available to support Norton Healthcare patients through their treatment plan, discuss lifestyle changes and connect them with our support group and other community resources.

In-person and online support groups meet monthly. After that, screening is recommended once a year. The exact cause of each type of neuropathy is unknown. Researchers think that over time, uncontrolled high blood sugar damages nerves and interferes with their ability to send signals, leading to diabetic neuropathy.

High blood sugar also weakens the walls of the small blood vessels capillaries that supply the nerves with oxygen and nutrients. Anyone who has diabetes can develop neuropathy. But these risk factors make nerve damage more likely:. You can prevent or delay diabetic neuropathy and its complications by closely managing your blood sugar and taking good care of your feet.

The American Diabetes Association ADA recommends that people living with diabetes have a glycated hemoglobin A1C test at least twice a year. This test indicates your average blood sugar level for the past 2 to 3 months. glycated hemoglobin A1C goals may need to be individualized, but for many adults, the ADA recommends an A1C of less than 7.

If your blood sugar levels are higher than your goal, you may need changes in your daily management, such as adding or adjusting your medications or changing your diet or physical activity.

Foot problems, including sores that don't heal, ulcers and even amputation, are common complications of diabetic neuropathy. But you can prevent many of these problems by having a thorough foot exam at least once a year.

Also have your health care provider check your feet at each office visit and take good care of your feet at home. Follow your health care provider's recommendations for good foot care. To protect the health of your feet:. On this page.

When to see a doctor. Risk factors. A Book: The Essential Diabetes Book. Peripheral neuropathy This type of neuropathy may also be called distal symmetric peripheral neuropathy.

Signs and symptoms of peripheral neuropathy are often worse at night, and may include: Numbness or reduced ability to feel pain or temperature changes Tingling or burning feeling Sharp pains or cramps Muscle weakness Extreme sensitivity to touch — for some people, even a bedsheet's weight can be painful Serious foot problems, such as ulcers, infections, and bone and joint damage.

Autonomic neuropathy The autonomic nervous system controls blood pressure, heart rate, sweating, eyes, bladder, digestive system and sex organs. Diabetes can affect nerves in any of these areas, possibly causing signs and symptoms including: A lack of awareness that blood sugar levels are low hypoglycemia unawareness Drops in blood pressure when rising from sitting or lying down that may cause dizziness or fainting orthostatic hypotension Bladder or bowel problems Slow stomach emptying gastroparesis , causing nausea, vomiting, sensation of fullness and loss of appetite Difficulty swallowing Changes in the way the eyes adjust from light to dark or far to near Increased or decreased sweating Problems with sexual response, such as vaginal dryness in women and erectile dysfunction in men.

Proximal neuropathy diabetic polyradiculopathy This type of neuropathy often affects nerves in the thighs, hips, buttocks or legs. Proximal neuropathy may include: Severe pain in the buttock, hip or thigh Weak and shrinking thigh muscles Difficulty rising from a sitting position Chest or abdominal wall pain.

Mononeuropathy focal neuropathy Mononeuropathy refers to damage to a single, specific nerve. Mononeuropathy may lead to: Difficulty focusing or double vision Paralysis on one side of the face Numbness or tingling in the hand or fingers Weakness in the hand that may result in dropping things Pain in the shin or foot Weakness causing difficulty lifting the front part of the foot foot drop Pain in the front of the thigh.

More Information. Types of diabetic neuropathy. Call your health care provider for an appointment if you have: A cut or sore on your foot that is infected or won't heal Burning, tingling, weakness or pain in your hands or feet that interferes with daily activities or sleep Changes in digestion, urination or sexual function Dizziness and fainting The American Diabetes Association ADA recommends that screening for diabetic neuropathy begin immediately after someone is diagnosed with type 2 diabetes or five years after diagnosis with type 1 diabetes.

Request an appointment. From Mayo Clinic to your inbox. Sign up for free and stay up to date on research advancements, health tips, current health topics, and expertise on managing health. Click here for an email preview. To provide you with the most relevant and helpful information, and understand which information is beneficial, we may combine your email and website usage information with other information we have about you.

If you are a Mayo Clinic patient, this could include protected health information. If we combine this information with your protected health information, we will treat all of that information as protected health information and will only use or disclose that information as set forth in our notice of privacy practices.

You may opt-out of email communications at any time by clicking on the unsubscribe link in the e-mail. But these risk factors make nerve damage more likely: Poor blood sugar control. Uncontrolled blood sugar increases the risk of every diabetes complication, including nerve damage.

Diabetes history. The risk of diabetic neuropathy increases the longer a person has diabetes, especially if blood sugar isn't well controlled.

Kidney disease. Diabetes can damage the kidneys. Kidney damage sends toxins into the blood, which can lead to nerve damage. Being overweight. Having a body mass index BMI of 25 or more may increase the risk of diabetic neuropathy. Smoking narrows and hardens the arteries, reducing blood flow to the legs and feet.

This makes it more difficult for wounds to heal and damages the peripheral nerves. Diabetic neuropathy can cause a number of serious complications, including: Hypoglycemia unawareness.

But people who have autonomic neuropathy may not experience these warning signs. Loss of a toe, foot or leg. Nerve damage can cause a loss of feeling in the feet, so even minor cuts can turn into sores or ulcers without being noticed.

In severe cases, an infection can spread to the bone or lead to tissue death. Removal amputation of a toe, foot or even part of the leg may be necessary. Urinary tract infections and urinary incontinence. If the nerves that control the bladder are damaged, the bladder may not empty completely when urinating.

Bacteria can build up in the bladder and kidneys, causing urinary tract infections. Nerve damage can also affect the ability to feel the need to urinate or to control the muscles that release urine, leading to leakage incontinence. Sharp drops in blood pressure. Damage to the nerves that control blood flow can affect the body's ability to adjust blood pressure.

Half of all people with diabetes have nerve damage. The good news is that you can help prevent or delay it by keeping your blood sugar as close to your target levels as possible. There are four main types of nerve damage.

You can have more than one type. Symptoms depend on the type of nerve damage you have and which nerves are affected. Your feet may be very sensitive to touch—even a bed sheet can hurt.

These are all symptoms of peripheral nerve damage. It generally starts in the feet, usually in both feet at once.

Sometimes amputation removal by surgery is necessary. Finding and treating foot problems early can lower your chances of developing a serious infection. Learn how to care for your feet , including how to check them yourself and what kind of shoes to wear.

Nerve damage can cause muscles in your digestive tract to slow down or stop working. Learn more about how diabetes can affect your digestion.

Autonomic nerve damage affects your heart, bladder, stomach, intestines, sex organs, or eyes. Symptoms may include:. Proximal nerve damage affects nerves in the thighs, hips, buttocks, or legs.

It can also affect the stomach and chest area. Focal nerve damage affects single nerves, most often in your hand, head, torso, or leg.

Keeping your blood sugar as close to your target range as possible is the best way to help prevent or delay nerve damage.