Neuropathy, a common complication of diabetes, is damage to the nerves that allow you to feel sensations such as pain. There are a number of ways that diabetes damages the nerves, and they are all linked to blood glucose (sugar) being too high for a long period of time.

Diabetes-related nerve damage can be painful, but it isn't severe in most cases. There are two major types of diabetic neuropathy: peripheral and autonomic.

Peripheral Neuropathy

The areas of the body most commonly affected by peripheral neuropathy are the feet and legs. Nerve damage in the feet can result in a loss of foot sensation, increasing your risk of foot problems like ulcers. Therefore, proper skin and foot care should be practiced. Rarely, the arms, abdomen, and back may be affected.

Symptoms of peripheral neuropathy may include:

Tingling
Numbness (severe or long-term numbness can become permanent)
Burning
Pain

In most cases, symptoms will become less when blood glucose is controlled.

To prevent peripheral neuropathy:

Check your feet and legs daily -- look for blisters, calluses, and cuts.
Apply lotion if your feet are dry but avoid getting lotion in between your toes; this area should be kept dry.
Care for your nails regularly. (Go to a podiatrist if necessary.)
Wear properly fitting footwear. Some people with bony abnormalities may require custom shoes to redistribute pressure.
People with claudication may require a referral to a doctor or surgeon who specializes in poor circulation.
Control blood sugar, cholesterol and high blood pressure
If you smoke, quit

Autonomic Neuropathy

Autonomic neuropathy most often affects the digestive system, especially the stomach, blood vessels, urinary system, and sex organs. To prevent autonomic neuropathy, you need to continuously keep your blood glucose levels well controlled.

Symptoms of neuropathy of the digestive system may include:

Bloating
Diarrhea
Constipation
Heartburn
Nausea
Vomiting
Feeling full after small meals
Frequent episode of labile blood sugar control

Treatments may include:

Eat smaller meals
Medicines

Symptoms of neuropathy of the blood vessels may include:

Blacking out when you stand up quickly
Increased heart rate
Dizziness
Low blood pressure

Treatments may include:

Avoid standing up quickly
Salt supplementation
Medicines
Wear special stockings

Symptoms of neuropathy of the male sex organs may include:

Unable to have or maintain an erection (erectile dysfunction)*
"Dry" or reduced ejaculations

Treatments include:

Counseling
Penile implant
External erection maintenance device
Penile injections
Medicine

Impotence needs to be evaluated by your doctor. It may be caused by your medicines or factors other than diabetes.

Symptoms of neuropathy of the female sex organs may include:

Decrease in vaginal lubrication
Decrease in number of orgasms or lack of orgasm

Treatments include:

Counseling
Estrogen
Vaginal creams
Lubricants

Symptoms of neuropathy of the urinary system may include:

Unable to completely empty bladder
Increased urinary tract infections
Bloating
Incontinence (leaking urine)
Increased urination at night

Treatments include:

Medicines
Self-catheterization (inserting a catheter into the bladder to release urine)
Surgery

Reviewed by Certified Diabetes Educators in the Department of Patient Education and Health Information and by physicians in the Department of Endocrinology at The Cleveland Clinic.

WebMD Medical Reference provided in collaboration with the Cleveland Clinic