Diabetes can cause nerve damage over time, which may result in numbness, tingling or pain in a person's feet, legs, hands and arms. These symptoms are called diabetic neuropathies. The three types of neuropathy are peripheral, proximal and focal, with peripheral being most common. These nerve disorders usually take many years to develop.
The first symptom of diabetic neuropathy usually is numbness, tingling or pain in the patient's feet. These sensations tend to be minor and may go mostly unnoticed for several years. Eventually the symptoms may become more severe and spread to the legs and later to the hands and arms. Pain symptoms vary and may include extreme sensitivity to touch, burning sensations, piercing, throbbing, cramping or prickling as when a person's foot "falls asleep."
People with diabetic neuropathy usually have been diabetic for 25 years or longer. Neuropathy is more prevalent in people who have trouble keeping their blood glucose stable. It also is more common in people with high levels of body fat or high blood pressure, and in overweight individuals.
Peripheral neuropathy, the most common form, causes numbness or pain in the feet, legs, hands and arms. It also may cause muscle and ankle weakness, which results in the person walking differently. It can cause a condition called hammertoes, a deformity where toes become rigidly bent at the middle joint. With numb feet, blisters and sores develop because the person does not feel abnormal pressure on these areas. Diabetics must keep careful watch of their feet because minor problems can become dangerous infections if not treated promptly.
Proximal and Focal Neuropathy
Proximal neuropathy causes pain higher up on the legs, at the thighs, hips or buttocks. These symptoms typically occur only on one side. It can also cause leg weakness, sometimes severe enough for the person to need help moving from a sitting position to a standing one. Focal neuropathy manifests in sudden muscle weakness or pain anywhere in the body, most commonly in the lower back or pelvis, thighs, shins or feet. This can result from nerve compressions, which commonly cause pain on the inside of the foot or outside of the shin. Another frequent nerve compression disorder is carpal tunnel syndrome, which causes numbness, tingling and pain in the hands.
The only preventive measure is maintaining blood glucose levels within the normal range, or as close as possible. Over-the-counter and prescription pain medication, as well as physical therapy, can treat neuropathy once it occurs. Most occurrences of focal neuropathy improve on their own within weeks or months.