Symptoms

Tingling or burning in the arms and legs may be an early sign of nerve damage. These feelings often start in your toes and feet. You may have deep pain. This often happens in the feet and legs.

Nerve damage may cause you to lose feeling in your legs and arms. Because of this, you may:

• Not notice when you step on something sharp
• Not know you have a blister or small wound
• Not notice when you touch something too hot or too cold

People with diabetes may have problems digesting food. These problems can make your diabetes harder to control. 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:

• Light-headedness, or even fainting, when sitting or standing up
• Rapid heart rate

Neuropathy may "hide" angina. This is the warning chest pain for heart disease and heart attack. People with diabetes should learn other warning signs of a heart attack. 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.
• Not being able to tell when your blood sugar gets too low
• Bladder problems. You may leak urine. You may not be able to tell when your bladder is full. Some people are not able to empty their bladder.
• Sweating too much -- when the temperature is cool, when you are at rest, or at other unusual times

Treating and Preventing Nerve Damage from Diabetes

Treating diabetic neuropathy can make some symptoms of nerve problems better. The best way to keep the problem from getting worse is to have tight control of your blood sugar.

Your doctor can give you medicines to help with some of these symptoms.

• Medicines may help reduce painful symptoms in the feet, legs, and arms. They usually do not bring back loss of feeling.
• Your health care provider may give you medicines to help with problems going to the bathroom.
• Other medicines can help with erection problems.

You should also:

• Take care of your feet
• Have a careful foot examination when you see your health care provider. These exams can find small infections. They can also keep foot injuries from getting worse.

References

American Diabetes Association. Standards of medical care in diabetes -- 2010. Diabetes Care. 2010 Jan;33 Suppl 1:S11-61.

In the clinic. Type 2 diabetes. Ann Intern Med. 2007;146:ITC-1-15.

Update Date: 11/11/2012

Updated by: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.