Peripheral Neuropathy
                
Peripheral neuropathy is the most common type of diabetic neuropathy, and it affects the sensory nerves of your feet, legs, hands, and arms. These areas of your body may feel
                
- numb  - weak  - cold  - burning or tingling, like pins and needles
                
You may feel extreme pain in these areas of your body, even when they are touched lightly. You also may feel pain in your legs and feet when walking.
                
These feelings are often worse at night and can make it hard to sleep. Most of the time, you will have these feelings on both sides of your body, such as in both feet; however, they can occur just on one side.
                

                
You might have other problems, such as
                
- swollen feet  - loss of balance  - loss of muscle tone in your hands and feet  - a deformity or shape change in your toes and feet  - calluses or open sores on your feet
                
Autonomic Neuropathy
                
Autonomic neuropathy can affect your
                
- digestive system  - sex organs  - bladder  - sweat glands  - eyes  - heart rate and blood pressure  - ability to sense low blood glucose
                
Digestive system. Damage to nerves in your stomach, intestines, and other parts of your digestive system may
                
- make it hard to swallow both solid food and liquids  - cause stomach pain, nausea, vomiting, constipation, or diarrhea  - make it hard to keep your blood glucose under control
                
Your doctor or dietitian may advise you to eat smaller, more frequent meals; avoid fatty foods; and eat less fiber.
                
Sex organs. Damage to nerves in the sex organs may
                
- prevent a mans penis from getting firm when he wants to have sex, called erectile dysfunction or impotence. Many men who have had diabetes for several years have impotence.  - prevent a womans vagina from getting wet when she wants to have sex. A woman might also have less feeling around her vagina.
                
Bladder. Damage to nerves in your bladder may make it hard to know when you need to urinate and when your bladder is empty. This damage can cause you to hold urine for too long, which can lead to bladder infections. You also might leak drops of urine.
                

                
Sweat glands. Damage to nerves in your sweat glands may prevent them from working properly. Nerve damage can cause you to sweat a lot at night or while eating.
                
Eyes. Damage to nerves in your pupils, the parts of your eyes that react to changes in light and darkness, may make them slow to respond to these changes. You may have trouble seeing the lights of other cars when driving at night. Your eyes may take longer to adjust when you enter a dark room.
                

                
Heart rate and blood pressure. Damage to nerves that control your heart rate and blood pressure may make these nerves respond more slowly to changes in position, stress, physical activity, sleep, and breathing patterns. You might feel dizzy or pass out when you go from lying down to standing up or when you do physical activity. You also might have shortness of breath or swelling in your feet.
                

                
Ability to sense low blood glucose. Autonomic nerves also let you know when your blood glucose is low. Damage to these nerves can prevent you from feeling the symptoms of low blood glucose, also called hypoglycemia. This kind of nerve damage is more likely to happen if you have had diabetes for a long time or if your blood glucose has often been too low. Low blood glucose can make you
                
- hungry  - dizzy or shaky  - confused  - pale  - sweat more  - weak  - anxious or cranky  - have headaches  - have a fast heartbeat
                
Severe hypoglycemia can cause you to pass out. If that happens, youll need help bringing your blood glucose level back to normal. Your health care team can teach your family members and friends how to give you an injection of glucagon, a hormone that raises blood glucose levels quickly. If glucagon is not available, someone should call 911 to get you to the nearest emergency room for treatment.
                

                
Consider wearing a diabetes medical alert identification bracelet or necklace. If you have hypoglycemia and are not able to communicate, the emergency team will know you have diabetes and get you the proper treatment. You can find these bracelets or necklaces at your pharmacy or on the Internet. You can also ask your doctor for information on available products.
                
Other Neuropathies
                
Other types of neuropathies from diabetes can cause
                
- damage to the joint and bones of your foot, called Charcots foot, in which you cannot sense pain or the position of your foot  - carpal tunnel syndrome, in which a nerve in your forearm is compressed at your wrist, causing numbness, swelling, and pain in your fingers  - paralysis on one side of your face, called Bells palsy  - double vision or not being able to focus your eyes  - aching behind one eye