There are four different types of diabetic neuropathy. Each type affects completely different parts of the body in various ways. These types of neuropathy include peripheral, autonomic, proximal and focal.
Peripheral neuropathy is the most common type of diabetic neuropathy. It causes pain or loss of feeling in the extremities such as the toes, feet, legs, hands, and arms. Peripheral neuropathy is also known as distal symmetric neuropathy and sensorimotor neuropathy. Many diabetic patients have signs of neuropathy, but have no actual symptoms. Symptoms of peripheral neuropathy can include numbness, insensitivity to pain or temperature, tingling (burning or prickling) sensation, sharp pains, cramps, extreme sensitivity to touch, loss of balance or coordination. Typically, these symptoms worsen at night.
Peripheral neuropathy can also cause muscle weakness and loss of reflexes which can change the way a person walks. This weakness can cause foot deformities and other serious injuries to the foot.
This type of neuropathy causes changes in digestion, bowel and bladder function. It can also cause changes in sexual response and perspiration. Autonomic neuropathy also can affect the nerves that serve the heart, control blood pressure, and nerves in the lungs and eyes. Autonomic neuropathy is also said to cause hypoglycemia unawareness which is a condition where people no longer experience the warning signs of low blood glucose levels.
Proximal neuropathy causes pain usually in the thighs, hips or buttocks. It typically leads to weakness in the legs. The weakness in the legs can cause patients to not be able to go from a sitting to a standing position without help. Treatment is usually needed for the weakness and pain. Proximal neuropathy is also called lumbosacral plexus neuropathy, femoral neuropathy and diabetic amyotrophy.
This starts with pain in the thighs, hips, buttocks or legs on typically one side of the body. This type of neuropathy is much more common in patients with type 2 diabetes and older adults who have diabetes.
Focal neuropathy is a result of the sudden weakness of one nerve or a group of nerves. This causes weakness or pain. Focal neuropathy can affect any nerve in the body. This type of neuropathy appears suddenly and affects specific nerves usually in the head, torso or leg. It is painful and unpredictable and typically occurs most often in older adults with diabetes. It does not cause long-term damage and tends to improve on its own over time.
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