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Understanding the Different Types of Diabetic Neuropathy

Expertly reviewed by Dexter Macalintal, MD · Internal or General Medicine

Written by Fiel Tugade · Updated Aug 03, 2022

    Understanding the Different Types of Diabetic Neuropathy

    Diabetic neuropathy refers to a type of nerve damage that can take place when you have diabetes. High blood sugar levels can harm the nerves throughout the body, but it primarily affects the nerves in your hands and feet. This nerve damage can result in a variety of health issues, ranging from mild numbness to extreme pain. This can make it difficult for the patient to perform daily tasks.

    Nerve problems can occur at any time if you have diabetes. Oftentimes, as symptoms of diabetes often go unnoticed, neuropathy comes up as the first sign of diabetes. But in general, the longer you have diabetes, the more likely you are to develop neuropathy. In addition to that, neuropathy also affects approximately half of all diabetics.

    What Causes Diabetic Neuropathy?

    Diabetes can cause neuropathy in anyone. However, the following risk factors make a person more likely to suffer from diabetic neuropathy:

    • High blood sugar levels (glucose). High blood glucose levels cause chemical changes in the nerves, impairing their capacity to transmit signals. It can also harm blood vessels, which transport oxygen and nutrients to the nerves.
    • Metabolic factors. High triglyceride and cholesterol levels, in addition to glucose levels, are linked to an increased risk of neuropathy. Overweight or obese patients (those with a BMI of 25 or more) are also at a higher risk of getting diabetic neuropathy.
    • Inherited factors. Some genetic characteristics may predispose some people to nerve conditions more than others.
    • Diabetes history. The longer you have diabetes, the more likely you are to develop diabetic neuropathy, particularly if your blood sugar is poorly controlled.
    • Kidney disease. Diabetes can cause kidney damage. When the kidneys are damaged, toxins get into the bloodstream, which can cause nerve damage.
    • Smoking. When you smoke, your arteries narrow and harden, limiting blood flow to your legs and feet. This then makes wound healing more challenging and impacts the peripheral nerves.

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    What Are the Different Types of Diabetic Neuropathy and Their Respective Symptoms?

    Nerve damage can be classified into four different types and you may experience multiple types. Symptoms may vary depending on the type of nerve damage and what nerves are getting affected. 

    Peripheral Neuropathy

    This is the most prevalent type of diabetic neuropathy wherein it first affects the feet and legs with some tingling sensation. Some people may also describe it as feeling “pins and needles.” Afterwhich, the sensation gets to the hands and arms as well. 

    This condition is otherwise known as distal symmetric peripheral neuropathy which signs and symptoms are worse at night including:

    • Numbness or reduced ability to feel (things like pain or temperature changes)
    • Tingling or burning sensation
    • Sharp pains or cramps
    • Increased sensitivity to touch 
    • Serious foot problems (i.e., ulcers, infections, bone, and joint pain)

    You may be unaware of pressure or injuries that cause blisters or sores, that can cause infections, unhealed sores, or ulcers. There are also some cases when amputation is necessary to remove it.

    Autonomic Neuropathy

    This type refers to nerve damage from the nerves that control your internal organs for automatic functioning. It can impair your heart rate and blood pressure, as well as your digestive system, bladder, sex organs, sweat glands, and even your eyes.

    As a result, diabetes can damage nerves in any of these areas, potentially resulting in the following symptoms:

    • Hypoglycemia unawareness (lack of awareness of low blood sugar levels)
    • Bladder or bowel problems
    • Gastroparesis (slow stomach emptying)
    • Persistent nausea and vomiting, as well as loss of appetite
    • Changes in the eyes (how they adjust seeing from light to dark)
    • Diarrhea and constipation
    • Decreased sexual response (difficulty in getting an erection in men and vaginal dryness in women)
    • Sweating abnormalities
    • Impaired perception of pain
    • Digestive problems
    • Low blood pressure

    Proximal Neuropathy

    Proximal neuropathy, also known as diabetic amyotrophy, is a relatively rare type of diabetic neuropathy that affects about 1% of type 2 diabetes patients. It primarily affects older adults, but it can also strike those with newly diagnosed or well-controlled diabetes.

    It commonly affects nerves in the thighs, hips, buttocks, or legs. But, it can also have an impact on the abdomen and chest. 

    Symptoms typically manifest only on part of the body, but they can extend to the opposite. Some of which include:

    • Severe pain in hip and thigh, or buttocks area
    • Severe stomach pain
    • Difficulty in getting up from a sitting position
    • Eventual weak and shrinking thigh muscles


    As the name goes, mononeuropathy, or focal neuropathy, refers to damage to a specific nerve, which can be classified into two types: either cranial or peripheral. Thus, symptoms may vary according to the affected nerve. It usually takes place in the hand, head, torso, or leg, which may cause pain and discomfort in respective parts.

    Symptoms include:

    • Inability to focus eyes
    • Double vision
    • Aches behind one eye
    • Bell’s palsy (on one side of the face)
    • Tingling sensation or numbness in the fingers or hands
    • Hand weakness that causes you to drop things

    Prevention and Management for Diabetic Neuropathy

    Like any other diabetes complication, it is essential that you control your blood glucose, blood pressure, and even cholesterol levels. 

    Furthermore, it would also help to follow these steps to prevent nerve damage due to diabetes:

    • Be physically active and exercise regularly
    • Follow your diabetes meal plan
    • Quit smoking
    • Limit alcohol drinking 
    • Take your prescribed medicines 

    Key Takeaways

    Diabetic neuropathy is a severe diabetes complication that affects up to half of all diabetics. However, with consistent blood sugar management and a healthy lifestyle, you can often prevent or slow down its progression. 

    Symptoms of nerve damage usually appear gradually, so it is critical to recognize them early so you can act to prevent them from worsening.

    Learn more about Diabetic Complications here


    Hello Health Group does not provide medical advice, diagnosis or treatment.

    Expertly reviewed by

    Dexter Macalintal, MD

    Internal or General Medicine

    Written by Fiel Tugade · Updated Aug 03, 2022

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