Symptoms of Autonomic Neuropathy
Autonomic nerves send signals to and from your organs, and when they are damaged, it can lead to dangerous situations. “With autonomic neuropathy, you can lose your ability to tell when your blood sugar is low or if you have a heart attack,” Zangeneh says.
Symptoms can include:
- Erectile dysfunction
- Chronic diarrhea or constipation
- Problems with urination or frequent urinary tract infections
- Indigestion, nausea, vomiting, or abdominal pain
- Faintness or dizziness when you stand up
- Changes in the way your eyes adjust from light to dark
Autonomic and peripheral neuropathy don’t necessarily go together. “Do they coordinate with each other? No,” Zangeneh says. “Can you have one without the other? Yes.”
Other Kinds of Diabetic Neuropathy
Two other types of neuropathy may also be common in people who have diabetes.
Diabetic amyotrophy causes pain in your thigh that leads to a painful weakness of one leg, which usually resolves within 6 months to 2 years. Severe abdominal pain, in a band-like fashion, can also represent a form of neuropathy as a result of having diabetes for a long time.
Single nerve damage, or focal neuropathy, often happens suddenly. It "focuses" on one part of your body. “It’s like a shingles pain in one nerve, and it tends to go away on its own,” Saudek says. You may have trouble focusing your eyes or have double vision, or paralysis on one side of your face. Carpal tunnel syndrome -- numbness or tingling in the fingers, or pain radiating from the wrist up the arm -- is also one type of focal neuropathy.
Who Is Most at Risk for Diabetic Neuropathy?
People who’ve had poorly controlled diabetes for more than 10 years, or who have other complications of diabetes, are most at risk for diabetic neuropathy. But Zangeneh cautions that it's different for everyone.
“There are people who’ve had diabetes for 20 years who have no complications, and people with pre-diabetes who already have nerve damage,” he says. “There are no guarantees.” In the end, preventing and limiting diabetic nerve damage depends mostly on keeping your diabetes under control.
Medications may help relieve nerve pain and other symptoms. But keeping blood sugar levels under control through diet and medication, taking special care of your feet, and adopting a healthy lifestyle are critical. “Eat less, eat smart, eat slow, and exercise more,” Zangeneh says. “Become a partner in your care and work closely with your medical team. If you do that, you’ll lower your risk of complications.”