What to know about diabetic neuropathy

Learn about peripheral, proximal, autonomic, and mononeuropathy focal nerve damage due to diabetes.

Diabetic neuropathy is commonly associated with numbness and tingling in the feet. Neuropathy, however, can impact a lot more than the feet and in this post, we’ll discuss the different types you should be watching out for as a person managing diabetes. 

Diabetic nerve damage, also known as diabetic neuropathy, can occur when high blood sugar is not properly managed and, therefore, remains elevated for prolonged periods. If you’ve been living with diabetes long enough, you’re probably aware of the common symptoms associated with nerve damage as it relates to the feet – numbness, tingling, pain, swelling.

We’re familiar with these symptoms because the feet are among the more common areas of the body impacted by neuropathy. But they’re not alone. Diabetic neuropathy can also affect other parts of the body, in fact, there are four main types of diabetes-related nerve damage you should be aware of, so that you can spot them early and prevent further complications.

One common thread among all the types of diabetic neuropathy is that they tend to happen very gradually. Chances are you won’t feel or see any telltale signs until the condition has progressed and considerable nerve damage has occurred. If you notice any of the following symptoms we’re about to get into, it’s important to contact your diabetes physician right away. The sooner you identify the development of diabetic neuropathy, the sooner you can take steps to treat it and avoid more serious problems down the road.

So, let’s get into it, starting with the most prevalent form of diabetic neuropathy.


Peripheral Neuropathy

Peripheral neuropathy is the form of the disease that gets the most attention because it impacts the most people. The nerves in the appendages, usually starting with the feet and lower legs, are affected first, and are often followed by symptoms in the hands and arms. Signs of peripheral neuropathy include:

– Numbness

– Reduced ability to feel pain or changes in temperature (heat/cold)

– Burning or tingling sensation

– Sharp, stabbing pain that is often worse at night

– Extreme sensitivity to touch. For some even the weight of a bedsheet can be agonizing.

– Muscle weakness

– Loss of reflex response

– Foot problems such as ulcers, infections, joint damage, and wounds that won’t heal.

One of the big concerns with peripheral neuropathy is how profoundly it can inhibit sensation in the extremities, if left untreated. When a person doesn’t feel the pain normally associated with cuts, sores, blisters, or serious sprains, these problems tend to be ignored. Without proper care and treatment, simple wounds can lead to infection and even deformities in the feet.


Autonomic Neuropathy

Your autonomic system is responsible for regulating blood pressure, heart rate, sweat glands, bladder, eyes, digestion, and sex organs. High blood sugar can damage the nerves in any of these areas causing symptoms that can include: 

– Frequent urinary tract infections (UTIs)
– Loss of bladder control
– Constipation, diarrhea, or a combination of the two
– Nausea and/or vomiting
– Loss of appetite
– Erectile dysfunction in men
– Vaginal dryness and diminished sexual desire in women
– Sweating
– Increased resting heart rate
– Dizzy sensation when standing from a seated or lying position
– Changes in the way the eyes adjust from light to dark
– Having difficulty judging distances

Proximal Neuropathy

Just the way peripheral neuropathy can impact the feet and appendages, proximal neuropathy affects the nerves in the thighs, hips, or buttocks. Proximal neuropathy is more common among individuals with Type 2 diabetes versus those with Type 1 diabetes. It’s also more prevalent among older individuals who have been living with diabetes for some time. 

Symptoms often occur only on one side of the body. The good news is that proximal neuropathy tends to remedy itself at least partially over 6 months to a year – provided blood sugar is stabilized and remains properly managed.  Symptoms include:

– Severe pain in the impacted area – thigh, hip or buttock
– Weak and even shrinking thigh muscles
– Difficulty and/or pain when rising from a seated position
– Chest or abdominal pain


Also called focal neuropathy, this condition involves damage to a specific nerve, and it can be just about anywhere – the face, arm, leg, torso. This form of neuropathy often comes on suddenly and can cause severe pain, though it rarely causes long-term complications. The good news is that symptoms, while initially intense, tend to lessen before disappearing entirely after a few weeks or, at worst, a few months. Symptoms naturally depend on which never is impacted but may include: 

– Double vision or difficulty focusing the eyes
– Paralysis on one side of the face
– Pain in the shin or foot
– Pain in the front of the thigh

Mononeuropathy can also occur when a nerve is compressed, such as the case with carpal tunnel syndrome, a common condition among individuals with diabetes. Carpal tunnel is distinguished by numbness, pain, or tingling in hands, commonly felt in the thumb, index finger, middle finger, or ring finger. Carpal tunnel can also lead to a decrease in grip strength that may cause a person to drop things more often.



Diabetic neuropathy is one of the more common complications associated with prolonged high blood sugar, particularly among those with Type 2 diabetes who also may be suffering from obesity, which can further contribute to nerve damage and a lack of circulation. 

While diabetic neuropathy usually manifests in the peripheral form, impacting the feet and appendages, nerve damage can occur throughout the body. If you experience any of the signs listed above, contact your diabetes physician and care team right away. The sooner you identify the problem, the sooner you can begin treating it.

We hope you found this post informative and insightful. At Diabetic Warehouse, we’re committed to helping those with diabetes manage blood sugar with a complete selection of testing and treatment supplies at prices up to 65% less than those found at most pharmacies and suppliers. 

Diabetic Warehouse is a trusted supplier of diabetes care products and accessories. For more information and to explore a complete range of products, including glucose meters and test strips, insulin syringes, pen needles, continuous glucose monitoring systems, and more, visit

5 THOUGHTS ON “Types of Diabetic Neuropathy”

by Via Montana

info could not have come at a better time..TY so much for sharing

by Charlene Barksdale

Seems like I got all 3 neuropathy

by Marie

Thank you for this very informative article. I wasn’t aware that there so many different neuropathy types. I noticed a number of issues that I have fall into some categories I wasn’t aware of. Some I thought were just from getting older. I’ll be paying more attention to them going forward.

by Ronald Henry

I have tingling in my feet, and it’s the worst thing in my life, i wish I could find a way to get rid of it,

by Lee Bauer

Thank you! The article was interesting and most important informative.