Patient Guide to Diabetic Neuropathy

Diabetic Neuropathy Symptoms

Pain, Tingling, Numbness, and More

The symptoms of diabetic neuropathy depend on what type of neuropathy  you have. Symptoms are dependent on which nerves have been damaged. In general, diabetic neuropathy symptoms develop gradually; they may seem like minor and infrequent pains or problems at first, but as the nerves become more damaged, symptoms may grow.

diabetic neuropathy

Don’t overlook mild symptoms. They can indicate the beginning of neuropathy. Talk to your doctor about anything you notice—such as any pain, numbness, weakness, or tingling—even if it seems insignificant.  Your pain may mean the control of your diabetes could be improved, which will can help slow down the progression of your neuropathy. Pain and numbness are also important warning signs to take very good care of your feet, so you can avoid wounds and infections that can be difficult to heal and even raise risk for amputation. 1

Peripheral Neuropathy Symptoms

Peripheral neuropathy affects nerves leading to your extremities—the feet, legs, hands, and arms. The nerves leading to your feet are the longest in your body, so they are the most often affected nerves (simply because there’s more of them to be damaged). Peripheral neuropathy is the most common form of diabetic neuropathy.

Peripheral neuropathy symptoms include:

  • Pain
  • Burning, stabbing or electric-shock sensations
  • Numbness (loss of feeling)
  • Tingling
  • Muscle weakness
  • Poor coordination
  • Muscle cramping and/or twitching
  • Insensitivity to pain and/or temperature
  • Extreme sensitivity to even the lightest touch
  • Symptoms get worse at night. 2, 3

Autonomic Neuropathy Symptoms

The autonomic nervous system is in charge of the "involuntary" functions of your body. It keeps your heart pumping and makes sure you digest your food right—without you needing to think about it.

Autonomic neuropathy symptoms include:

Cardiovascular System

  • Dizziness just after standing
  • Fainting just after standing
  • Irregular heart rate
  • Quickly feeling tired and weak when you exercise. 4

Digestive System

  • Bloating
  • Constipation
  • Diarrhea
  • Nausea
  • Vomiting
  • Feeling full soon after you start eating.
  • The feeling that food isn’t moving through your digestive system – called gastroparesis.
  • Big blood-sugar swings (because digested food is reaching your intestines, where glucose is absorbed into the bloodstream, at irregular times). 5


  • Vision trouble at night or during sudden light changes (e.g., when stepping into a dark building from the sunlight)

Reproductive System

  • Sexual problems—erectile dysfunction in men; vaginal dryness in women; difficulty reaching orgasm for both.

Sweat Glands

  • Profuse sweating, especially at night or when eating particular foods (cheese commonly causes excessive sweating, for example, although that’s not true for every person with diabetic neuropathy)
  • Reduced sweating, especially in the legs and feet
  • Dry, flaky, thinning skin
  • Hair loss. 6

Urinary System

  • Incontinence
  • Frequent or urgent urination
  • Waking up often during the night to urinate
  • Trouble urinating.

People with autonomic neuropathy may also have trouble figuring out when their blood sugar level is too low—which is particularly dangerous for people with diabetes. This is called “hypoglycemia unawareness,” and it occurs when the normal responses to low blood sugar (sweating, shakiness, etc.) don’t kick in because of nerve damage.

Again, your symptoms depend on which autonomic nerves are damaged and which part of the body’s autonomic system they control.

Proximal Neuropathy Symptoms

Proximal neuropathy affects the buttocks, hips, thighs, and legs. Its symptoms aren’t usually long-term; they may go away after several weeks or months.

Symptoms include:

  • Weakness in the legs
  • Trouble standing up from a seated position without help
  • Sudden, severe pain pain in your hip, upper thigh and/or buttock on one side of the body
  • Pain or weakness in your arms after symptoms in your legs start improving

Focal Neuropathy Symptoms

Unlike the other types of diabetic nerve pain, focal neuropathy comes on suddenly, and it usually affects the head, torso, or legs. Symptoms usually go away after a few weeks; these aren’t long-term symptoms.

Possible focal neuropathy symptoms:


  • Vision trouble—double vision, ache behind an eye, difficulty focusing
  • Sudden paralysis of one side of the face (Bell’s palsy)


  • Pain in the chest
  • Pain in the stomach
  • Pain on the side
  • Pain in the low back


  • Pain in the front of the thigh
  • Pain on the outside of the shin
  • Pain on the inside of the foot




Continue Reading
Diabetic Neuropathy: Causes and Symptoms