Diabetes pain, usually from nerve damage (diabetic neuropathy), most often starts in the feet and toes, then spreads up the legs, and can also affect hands and arms, with symptoms like burning, tingling, sharp jabs, or numbness, often worsening at night. High blood sugar injures nerve endings, and the longest nerves (in the feet) are hit first, causing loss of feeling, increased sensitivity, and potential foot complications like ulcers.
Depending on the affected nerves, diabetic neuropathy symptoms may include pain and numbness in the legs, feet and hands. It also can cause problems with the digestive system, urinary tract, blood vessels and heart.
Symptoms of diabetes-related peripheral neuropathy
Pain, which may be burning, stabbing or shooting. Unusual touch-based sensations (dysesthesia). Muscle weakness. Slow-healing leg or foot sores (ulcers).
It often starts in the feet, usually affecting both feet at the same time. Most often, peripheral neuropathy symptoms affect both sides of the body. The symptoms can include: Numbness or less ability to feel pain or temperature changes, especially in the feet and toes.
Autonomic neuropathy can also cause erectile dysfunction (ED) when it affects the nerves that control erection with sexual arousal. However, sexual desire does not usually decrease. Diarrhea can occur when the nerves that control the small intestine are damaged. The diarrhea occurs most often at night.
Symptoms of peripheral neuropathy might include: Gradual onset of numbness, prickling, or tingling in your feet or hands. These sensations can spread upward into your legs and arms. Sharp, jabbing, throbbing or burning pain.
Abdominal Pain: Diarrhea may be accompanied by cramping or bloating in the abdominal area, which can be a result of gastrointestinal distress or nerve damage. Frequent Bowel Movements: Individuals with diabetic diarrhea may experience an increased frequency of bowel movements, often several times a day.
Peripheral neuropathy testing
The first clinical sign that usually develops in diabetic symmetrical sensorimotor polyneuropathy is decrease or loss of vibratory and pinprick sensation over the toes.
A lack of B12 damages the myelin sheath that surrounds and protect nerves. Without this protection, nerves cease to function properly and conditions such as peripheral neuropathy occur. Even B12 deficiency that is relatively mild may affect the nervous system and the proper functioning of the brain.
Neuropathy can be triggered by various factors such as diabetes, nutritional deficiencies, medication side effects, alcohol use, and autoimmune conditions. Identifying these triggers is key to managing symptoms effectively.
Both type 1 and type 2 diabetes can have similar symptoms, including:
To stop nerve pain immediately, topical lidocaine or capsaicin creams/patches can provide quick numbing relief, while prescription options like anti-seizure drugs (gabapentin) or strong painkillers (tramadol) offer faster but not always instant relief; gentle stretches, TENS, and relaxation techniques can also help manage acute flare-ups by blocking pain signals or relaxing muscles.
Diabetic cheiroarthropathy is also called diabetic hand syndrome or stiff hand syndrome. People with this complication of diabetes lose mobility in their hands. Diabetic cheiroarthropathy affects around 30% of patients with poorly managed type 1 and type 2 diabetes.
Symptoms of hyperglycaemia
The most common diabetic neuropathy symptoms include numbness or tingling in the toes or feet, prickly or sharp pain, burning, pinching, pins and needles, or an exaggerated sensitivity to touch.
Feeling very thirsty. Feeling very hungry—even though you are eating. Extreme fatigue. Blurry vision.
Seven vitamins known to support nerve repair are B1 (thiamine), B2 (riboflavin), B6 (pyridoxine), B12 (cobalamin), Vitamin D, Vitamin E, and Vitamin C. These vitamins promote nerve regeneration, reduce inflammation, and provide antioxidant protection to support overall nerve health.
Neurological symptoms can include: Numbness or tingling in your hands and feet. Vision problems. Having a hard time remembering things or getting confused easily.
The signs of nerve damage include the following:
To figure out if you have diabetic neuropathy, your healthcare professional gives you a physical exam. You're also asked questions about your symptoms and medical history. During the exam, your healthcare professional most often checks: Your overall muscle strength and tone.
Some of the symptoms of type 1 diabetes and type 2 diabetes are: Feeling more thirsty than usual. Urinating often. Losing weight without trying.
Try using a pillow between your legs if you are sleeping on your side, or use a foam wedge to elevate your head and shoulders if you are sleeping on your stomach.
Gastrointestinal symptoms occur commonly in people with diabetes, and include gastro-esophageal reflux, bloating, nausea, constipation, diarrhea, and fecal incontinence.
Signs that your diabetes may be getting worse
Using bismuth subsalicylate together with insulin or certain other diabetes medications may increase the risk of hypoglycemia, or low blood sugar.