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	Diabetes: Taking Care of Your Feet

Symptoms

Diabetic neuropathy—especially peripheral neuropathy—initially may not cause any noticeable symptoms. If you have diabetes, it is important to have regular medical checkups to check for signs of neuropathy and treat problems before they become serious.

Symptoms of diabetic neuropathy may vary depending on the type of neuropathy you have.

Symptoms of peripheral neuropathy

Peripheral neuropathy tends to develop slowly over months or years. In general, symptoms may include:

• Tingling, numbness, tightness, or burning, shooting, or stabbing pain in the feet, hands, or other parts of the body. Bone and joint deformities can develop, especially of the feet (such as Charcot foot). See a picture of Charcot foot.
• Reduced feeling or numbness, most often in the feet. Check your feet every day for skin problems (chapped, broken skin or excessive dryness) or minor injuries (blisters, calluses, or ingrown toenails). People who have had diabetes 10 or more years, who have poor blood sugar control, or who have blood vessel, kidney, or eye complications are at increased risk for foot and leg sores and possible amputation.
• Greatly reduced or greatly increased sensitivity to light touch or temperature.
• Weakness and loss of balance and coordination.

Symptoms of autonomic neuropathy

Autonomic neuropathy may affect digestion, the body's ability to regulate temperature, urination, sexual function, and heart and blood vessel function, including blood pressure. Symptoms may get worse during pregnancy. In general, symptoms may include:

• Frequent bloating, belching, constipation, heartburn, nausea and vomiting, diarrhea, and abdominal pain. These symptoms may indicate gastroparesis, a condition that causes the stomach to empty much slower than normal.
• Profuse sweating of the torso, face, or neck at night or while eating certain foods, such as spicy foods and cheese. Alternatively, some people may have reduced sweating, especially in their feet and legs.
• Difficulty sensing when the bladder is full or difficulty emptying the bladder completely.
• Sexual problems, such as erection problems in men and vaginal dryness in women.
• Dizziness, weakness, or fainting when you stand or sit up from a reclining position (orthostatic hypotension).
• Difficulty knowing when your blood sugar is low (hypoglycemia unawareness).

Symptoms of focal neuropathy

Symptoms of focal neuropathy usually appear suddenly. They may include:

• Pain, weakness, and motor problems in a single area of the body, such as a wrist, thigh, or foot. In cases of a compressed or pinched nerve, soreness and pain may develop more gradually over several weeks or months.
• Pain in and around one of your eyes, difficulty moving the eyes, and double vision. Focal neuropathy may sometimes affect the nerves that control your eye muscles.

Symptoms of focal neuropathy usually get better over time. But focal neuropathy may be permanent.