DPN Symptoms

Symptoms of Diabetic Peripheral Neuropathy

The symptoms of diabetic peripheral neuropathy vary. Numbness and tingling in one or both feet are often the first signs. Some people notice no symptoms, while others are severely disabled. Neuropathy may cause both pain and insensitivity to pain in the same person. Often, symptoms are slight at first, and since most nerve damage occurs over a period of years, mild cases may go unnoticed for a long time. A healthcare provider may prescribe an over-the-counter or prescription pain medication. These medications may relieve symptoms, but will not halt the progression of neuropathy.

Symptoms vary from each patient and may include:6

  • Numbness/insensitivity to touch or pain
  • Extreme sensitivity to touch
  • Sharp pains or cramps
  • Loss of balance or coordination
  • Loss of reflexes and muscle weakness
  • Burning sensation in the hands, lower legs and/or feet


Neuropathy Progression Diabetic Peripheral Neuropathy is A Progressive Disease.7

An international group of experts in DPN held a consensus meeting to develop guidelines for the management of diabetic peripheral neuropathy by the practicing clinician. The agreed stages of DPN are shown here.

Major Types of Neuropathy2

The symptoms of neuropathy also depend on which nerves and what part of the body is affected. Neuropathy may be diffuse, affecting many parts of the body, or focal, affecting a single, specific nerve and part of the body.

Diffuse Neuropathy2

The two categories of diffuse neuropathy are peripheral neuropathy, affecting the feet and hands, and autonomic neuropathy, affecting the internal organs.

Diabetic Peripheral Neuropathy Can Affect Virtually Every Part of the Body2

Diabetic Neuropathy Affects the BodyDiffuse (peripheral) neuropathy:

  • Legs
  • Feet
  • Arms
  • Hands

Diffuse (Autonomic) neuropathy:

  • Heart
  • Digestive System
  • Sexual Organs
  • Urinary Tract
  • Sweat Glands

Focal neuropathy:

  • Eyes
  • Facial Muscles
  • Hearing
  • Pelvis and Lower Back
  • Thigh
  • Abdomen


How do you Know you Have Peripheral Neuropathy?2

A healthcare provider can diagnose neuropathy based on symptoms and a physical exam. During the exam, the healthcare provider may check muscle strength, reflexes, and sensitivity to position, vibration, temperature, and light touch. Sometimes special tests are also used to help determine the cause of symptoms and to suggest treatment. These include:

  • Monofilament test
  • Nerve conduction studiesFilament Test
  • Electromyography (EMG)
  • Ultrasound
  • Nerve Biopsies
  • Quantitative Sensory Testing (QST)

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