The Nerve Damage of Diabetes
Autonomic Neuropathy (Also Called Visceral Neuropathy)
Autonomic neuropathy is another form of diffuse neuropathy. It affects the
nerves that serve the heart and internal organs and produces changes in many
processes and systems.
Urination and Sexual Response
Autonomic neuropathy most often affects the
organs that control urination and sexual function. Nerve damage can prevent the
bladder from emptying completely, so bacteria grow more easily in the urinary
tract (bladder and kidneys). When the nerves of the bladder are damaged, a
person may have difficulty knowing when the bladder is full or controlling it,
resulting in urinary incontinence.
The nerve damage and circulatory problems of
diabetes can also lead to a gradual loss of sexual response in both men and
women, although sex drive is unchanged. A man may be unable to have erections
or may reach sexual climax without ejaculating normally.
Autonomic neuropathy can affect digestion.
Nerve damage can cause the stomach to empty too slowly, a disorder called
gastric stasis. When the condition is severe (gastroparesis), a person can have
persistent nausea and vomiting, bloating, and loss of appetite. Blood glucose
levels tend to fluctuate greatly with this condition.
If nerves in the esophagus are involved,
swallowing may be difficult. Nerve damage to the bowels can cause constipation
or frequent diarrhea, especially at night. Problems with the digestive system
often lead to weight loss.
Autonomic neuropathy can affect the
cardiovascular system, which controls the circulation of blood throughout the
body. Damage to this system interferes with the nerve impulses from various
parts of the body that signal the need for blood and regulate blood pressure
and heart rate. As a result, blood pressure may drop sharply after sitting or
standing, causing a person to feel dizzy or light-headed, or even to faint
Neuropathy that affects the cardiovascular
system may also affect the perception of pain from heart disease. People may
not experience angina as a warning sign of heart disease or may suffer painless
heart attacks. It may also raise the risk of a heart attack during general
Autonomic neuropathy can hinder the body's normal response to low blood
sugar or hypoglycemia, which makes it difficult to recognize and treat an
Autonomic neuropathy can affect the nerves that control sweating. Sometimes,
nerve damage interferes with the activity of the sweat glands, making it
difficult for the body to regulate its temperature. Other times, the result can
be profuse sweating at night or while eating (gustatory sweating).
Focal Neuropathy (Including Multiplex Neuropathy)
Occasionally, diabetic neuropathy appears
suddenly and affects specific nerves, most often in the torso, leg, or head.
Focal neuropathy may cause:
- Pain in the front of a thigh
- Severe pain in the lower back or pelvis
- Pain in the chest, stomach, or flank
- Chest or abdominal pain sometimes mistaken for angina, heart
attack, or appendicitis
- Aching behind an eye
- Inability to focus the eye
- Double vision
- Paralysis on one side of the face (Bell's palsy)
- Problems with hearing