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Does the light touch of a bed sheet make your feet burn? Does your heart sometimes race when you’re resting? Do you have problems with sexual arousal?

As different as these symptoms are, they can all have the same cause: diabetic nerve damage, also known as diabetic neuropathy. About half of people with diabetes develop nerve damage. The two most common forms are:

  • peripheral neuropathy, which affects the nerves that serve the farthest reaches of the body, such as the legs and hands;
  • autonomic neuropathy, which affects nerves that serve parts of the autonomic system that control a range of body function, including heart rate, blood pressure, sexual arousal, and sweating.

If it progresses, diabetic nerve damage can lead to serious health problems. But it doesn’t have to progress. Keeping your blood sugar levels under control may not only reduce your risk of developing neuropathy by as much as 60%, it can also limit the damage and improve the symptoms if you already have neuropathy. That’s why it’s so important to recognize the symptoms of diabetic nerve damage.

Symptoms of Peripheral Neuropathy

Peripheral neuropathy is the most common kind of diabetic nerve pain. It usually hits feet first. “It starts in the longest nerves, which are in the feet, and tends to work up toward the center,” says Christopher Saudek, MD, professor of medicine at Johns Hopkins University, and director of the Johns Hopkins Diabetes Center. “The symptoms can range from a mild sense of numbness to electric-type shooting pains or tingling, and they’re often worse at night.”

Talk to your diabetes doctor if you have these symptoms in your feet, legs, arms, or hands:

  • Tingling, burning, or prickling, which often starts in your toes or the balls of the feet and spread upward
  • Numbness or loss of sensation, so you don’t feel cold, heat, or pain
  • Sharp or jabbing pain
  • Muscle weakness and difficulty walking
  • Loss of coordination or balance 
  • Extreme sensitivity even to light touch
  • Foot problems such as pain, ulcers, or infections

Severe peripheral nerve damage can cause your feet to be numb, a special problem for people with diabetes, who may not be able to tell when cuts and blisters occur. "Once you have numbness, you have lost your main line of defense against injury,” says Farhad Zangeneh, MD, assistant professor at George Washington University School of Medicine and medical director of the Endocrine, Diabetes and Osteoporosis Clinic in Sterling, Va.

Examining your feet every day, looking between and underneath each toe, protecting feet from injury, and wearing properly fitted shoes are critical to prevent even small cuts and scrapes from becoming infected or ulcerated.

Exercises to Ease Nerve Pain

Simple moves and tips to help you avoid pain and falls.
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Know Your Nerve Pain Risk

Is your diabetes putting you at higher risk?