Pictures of Diabetic Neuropathy

Medically reviewed by Peggy Pletcher, MS, RD, LD, CDE on December 15, 2016Written by Colleen M. Story

What is diabetic peripheral neuropathy (DPN)?

The Foundation for Peripheral Neuropathy reports that 40 million Americans experience some form of peripheral neuropathy. Of these, 20 million have diabetic peripheral neuropathy (DPN). This makes DPN the most common form of peripheral neuropathy.

DPN affects the nerves in the hands and feet, causing sensations like:

  • numbness
  • tingling
  • pain

Nerve problems may also occur in your:

  • digestive tract
  • heart
  • eyes
  • other organ systems

Potential causes of nerve damage include:

  • high blood sugar levels
  • having had diabetes for a long time
  • low levels of insulin or treatment with insulin
  • inflammation in the nerves
  • lifestyle factors, like smoking or alcohol use

Tingling and numbness

Scientists aren’t sure exactly how diabetes damages nerves. Some think that excess blood sugar affects the protective coating on nerves.

Other scientists believe decreased blood flow to the nerves can cause damage.

Either way, as the disease progresses, you may feel a tingling or numbness in your extremities, including:

  • fingers
  • toes
  • hands
  • feet

You may also have a “pins-and-needles” feeling, or even a burning sensation.

Shooting pain

A nerve that’s pinched or damaged may send out signals that cause shooting pains. People also describe this sensation as an electric shock, or a sharp, stabbing pain.

The pain may be the result of damaged nerves that are misfiring, or sending out mistaken signals to the brain.

The sensations usually come and go. They may also remain constant at times. These types of pains are most common at night, and can disturb your sleep.

Extreme sensitivity

Imagine how you feel if someone touches an open wound on your body. Diabetic neuropathy can cause similar sensations.

When the protective covering of a nerve is damaged, you may experience extreme sensitivity in that area.

At its most severe, this type of neuropathy can cause extreme pain when the area is only gently brushed or touched. If you have severe neuropathy, you may not be able to tolerate even something soft brushing across your foot, or sheets over your body at night.

Muscle weakness

Nerves control your muscles. When nerves are damaged, you become less able to control muscle movement.

Diabetes also damages blood vessels, which can affect blood flow to the muscles. Diabetes often affects your muscles to the point that they weaken. As a result, you may experience a gradual decline in muscle strength.

Muscle weakness is a common symptom of nerve damage, according to the National Institute of Neurological Disorders and Stroke. Over time, it may progress to muscle twitching and actual muscle loss.

Inability to feel hot and cold

Your nerves help you sense the world around you. They are how you notice when you’re feeling hot or cold. They also tell you when you’ve stubbed a toe or experienced a paper cut.

Severely damaged nerves can die off. If this happens, you may suddenly be unable to tell when you’ve stepped on a tack or developed a blister. That means you may not notice small injuries. So they may go untreated and later cause other complications.

Foot problems

If you lose function in some of the nerves in your feet, you may not notice the following skin conditions at first:

  • blister
  • ulcer
  • wound

And you may not notice the condition until it becomes:

  • infected
  • swollen
  • inflamed

Doctors recommend that if you have diabetes, you check your feet and hands daily for injuries, especially if you’ve experienced nerve damage and lack feeling in your fingers or toes.

Difficulty walking and performing other daily tasks

It’s because of our nerves that you can perform many everyday activities, such as:

  • buttoning up a shirt
  • walking
  • opening a door

Nerve damage in the hands and feet can make these everyday tasks more difficult, or even impossible.

Tools that can help are available. These include:

  • specialized orthotic inserts
  • diabetic shoes
  • gripping tools

Nerve damage can lead to changes in the shape of the foot itself. This can require shoe-fitting adjustments.

Autonomic symptoms

Did you know that nerves control the digestive system? Nerves are also involved in other bodily functions, including:

  • perspiration
  • sexual function
  • heart rate
  • urinary function
  • temperature regulation

If diabetes affects any of the nerves that control these functions, you may experience the following symptoms:

  • stomach upset, including constipation, diarrhea, nausea, vomiting
  • urinary problems, such as incontinence or urinary tract infections
  • erectile dysfunction or vaginal dryness
  • inability to stay warm or cool
  • difficulty focusing your eyes
  • dry, cracked skin
  • inability to feel low blood sugar

Coping with nerve damage

To avoid or limit any of these symptoms, concentrate on controlling your blood sugar levels. The more you can keep your levels in the normal range, the slower any nerve damage will progress.

Other steps you can take include:

  • exercising regularly
  • managing your weight
  • reducing stress

Talk to your doctor about lifestyle changes and tools that can help you cope if nerve damage has occurred. Medications are available to help reduce symptoms.

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