Understanding the Types of Diabetic Neuropathy

If you have diabetes, and you also experience numbness, tingling, oversensitivity, weakness, or sharp pain, you may also have diabetic neuropathy. There are four main types of diabetic neuropathy, which are:

• Peripheral neuropathy
• Autonomic neuropathy
• Focal neuropathy
• Proximal neuropathy

In this blog, the experts at CHOICE Pain & Rehabilitation Center discuss the symptoms of these four conditions and how they can be treated.

Peripheral neuropathy

About 50% of people with Type 2 diabetes end up with peripheral neuropathy to some degree. This is the most common type of diabetic neuropathy. 

What it feels like

Diabetic peripheral neuropathy (DPN) tends to show up first in your outer extremities, meaning your feet and hands. If left untreated, it usually progresses to your arms and legs. 

The classic signs of DPN are numbness and tingling. Some people describe temperature changes and even burning sensations. Others talk about sharp pains and cramps. Muscle weakness and loss of coordination have also been reported.

Diabetic peripheral neuropathy is also the primary cause of foot problems among diabetics. If you lose feeling in your feet, it can be hard to know if you cut yourself or get a blister. 

How we treat it

Because peripheral neuropathy can be caused by other medical conditions, the first thing we do is run tests to make sure your nerve damage is the result of diabetes and not something else.

If it’s DPN, we start with simple treatments and progress to more assertive measures if necessary. These include:

• Proper footwear
• Analgesics and nonsteroidal anti-inflammatory drugs, such as ibuprofen
• Control blood sugar with medication
• Physical therapy

Autonomic neuropathy

About 26 million people in the United States suffer from diabetic autonomic neuropathy (DAN), and many don’t know it until things get bad. This type affects the nerves responsible for controlling your perspiration, digestive system, bladder and bowels, blood pressure, and heart rate. Damage to these nerves can cause serious health problems.

Diabetic autonomic neuropathy can also make it difficult for you to recognize when your blood sugar has dropped too low. Under normal circumstances, you would begin to shake when your blood glucose plummets, but not when you have DAN.

Depending on which organ or nerve system DAN effects, you could experience a range of symptoms.

What it feels like

• Racing heart
• Sharp drop in blood pressure (dizzy, faint)
• Difficulty swallowing
• Nausea, vomiting
• Incontinence
• Erectile dysfunction
• Vision problems
• Night sweats

How we treat it

Among other options, we may recommend following a strict diet, exercising, wearing compression socks, modifying behavior, and taking medications to control symptoms, such as nausea, sexual challenges, and blood pressure problems.

Focal neuropathy

While other types of nerve damage can affect nerves throughout your body, diabetic focal neuropathy targets one specific area, such as your eyes, thighs, facial muscles, stomach, or back.

What it feels like

• Achy eyes and blurry vision
• Pelvic or back pain
• Chest pain that feels like a heart attack
• Hearing problems and ear pain
• Painful thighs
• Partial facial paralysis

How we treat it

• Medication to reduce related inflammation
• Splint or brace to remove pressure from affected nerves
• Acupuncture

Proximal neuropathy

Although rare, diabetics can suffer from proximal neuropathy, a condition that usually affects the legs. This type of neuropathy comes on quickly and is asymmetrical, meaning it affects one side or the other. It’s often so debilitating that sufferers need a wheelchair when they’re experiencing symptoms.

There is no cure for proximal neuropathy but left untreated, most people get better in 3-6 months. So treatment focuses on pain management and shortening the recovery period. 

What it feels like

• Sudden onset of pain in the upper leg
• Severe weakness
• Lack of knee reflexes
• Gradual involvement of the lower limb

How we treat it

• Topical pain relievers
• Prescription pain relievers
• Acupuncture
• Antidepressants, if necessary
• Proper nutrition
• Physical therapy

Neuropathy isn’t inevitable if you have diabetes, but it is very common. If you’re experiencing any of the aforementioned symptoms, we can help. To learn more, book an appointment online or over the phone with CHOICE Pain & Rehabilitation Center today.