Symptoms

Your symptoms depend on which complication type 1 diabetes has caused.

Eye disease

There are no symptoms in the early stages of diabetic retinopathy. Symptoms that are noticed in later stages of the disease include:

• Blurred or distorted vision or difficulty reading that does not go away. Macular edema or other changes in the retina cause these symptoms. Temporary vision problems can crop up when your blood sugar level is high.
• Floaters or flashes of light in your field of vision. Retinal detachment or bleeding into the fluid within the eye (vitreous gel) causes these symptoms.
• Partial or total loss of vision, or a shadow or veil across your field of vision. Retinal detachment or bleeding into the vitreous gel also causes these symptoms.
• Pain in your eye. Neovascular glaucoma can cause this problem.

For more information, see the topic Diabetic Retinopathy.

Kidney disease

The only sign of diabetic nephropathy in its early stage is tiny amounts of protein in your urine (microalbuminuria). A urine test for protein is the only way to identify this problem. Frothy or foamy urine can be a sign of excess protein. As kidney disease gets worse, you may have:

• Swelling (edema) in your feet and legs and, if severe, throughout your body.
• Increasing blood pressure.
• Large amounts of protein leaking into your urine (macroalbuminuria).
• High levels of cholesterol and triglycerides in your blood.
• An increased risk of developing blood clots.

Kidney damage affects your body's ability to rid itself of excess insulin. This results in low blood sugar levels. It also may mean that your doctor may want to adjust your insulin dose. As the disease gets worse, kidney failure develops. You may be tired, lose your appetite, and lose weight.

For more information, see the topic Diabetic Nephropathy.

Heart and large blood vessel disease

You may have chest pain (angina) or leg pain during exercise if you have macrovascular disease. But you may not have any symptoms until you have a heart attack or stroke or develop peripheral arterial disease. Because diabetes can affect the nerves, you may have no pain during a heart attack. This is called a "silent heart attack."¹

For more information, see the topics:

• High Blood Pressure (Hypertension).
• Coronary Artery Disease.
• Heart Attack and Unstable Angina.
• Peripheral Arterial Disease of the Legs.
• Stroke.

Nerve damage

Symptoms of peripheral neuropathy include:

• Tingling, numbness, tightness, burning, or shooting or stabbing pain in the feet, hands, or other parts of your body. Usually, symptoms start in the toes and are worse in the evening. Bone and joint deformities can develop, especially of the feet (Charcot foot and/or foot drop).
• Reduced feeling or numbness, most often in the feet.
• Reduced sweating, especially in your feet and legs.
• Greatly reduced or greatly increased sense of pain from a light touch or change in temperature.
• Weakness and loss of balance and coordination.

Symptoms of autonomic neuropathy (affecting internal functions) include:

• Digestive problems, including frequent bloating, belching, constipation, nausea and vomiting, diarrhea, and abdominal pain. These symptoms may indicate that you have gastroparesis, a condition that causes your stomach to empty too slowly.
• Temperature control problems, including profuse sweating on your chest, face, or neck at night or while eating certain foods, such as cheese and spicy foods.
• Leaking urine or having difficulty emptying your 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 (affecting a single nerve) usually develop suddenly and may include:

• Pain, weakness, and movement difficulty in a single area of your body, such as a wrist, thigh, or foot.
• Pain in and around one of your eyes (if neuropathy affects the nerves that control eye muscles), difficulty moving your eyes, and double vision.

For more information, see the topic Diabetic Neuropathy.