When blood sugar levels are too high or too low, diabetics can suffer physical damage, including diabetic neuropathy, which causes painful symptoms from damaged nerves.

Diabetes disrupts blood sugar levels due to inadequate insulin production or an inability for the body’s cells to respond properly to insulin. Medication and diet help to control blood sugar levels, but some patients still face the risk of neuropathy, which appears to happen most often from long-term high blood sugar levels, according to WebMD.

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Symptoms may differ among the four main types of diabetic neuropathy, the medical website said:

1. Peripheral neuropathy results in damaged nerves in the feet and legs, although rarely the arms, back, and abdomen may be involved. Symptoms may include numbness, tingling, and pain. Sufferers may experience sharp pains or cramps, weakness, loss of balance, and increased sensitivity to touch, WebMD said.

2. Autonomic neuropathy affects the digestive system, including the stomach, and may cause bloating, nausea, heartburn, vomiting, a feeling of fullness following a small meal, constipation, or diarrhea, WebMD said.

The blood vessels may also be affected from autonomic neuropathy, causing a faster heartbeat, dizziness, fainting when standing up quickly, low blood pressure, nausea, vomiting, or indigestion, according to the Mayo Clinic. Urinary difficulties may also arise. Men may suffer erectile dysfunction and women could experience less vaginal lubrication.

There may also be difficulty swallowing, increased or decreased sweating, problems regulating body temperature, and changes in the way the eyes focus from light to dark.

3. Proximal neuropathy, also called radiculoplexus neuropathy, causes pain or weakness in the thighs, hips, or buttocks, usually on one side, WebMD said. Symptoms include sudden or severe pain, weak, and atrophied thigh muscles, abdominal swelling, or weight loss. It occurs more frequently in people with Type 2 diabetes.

4. Focal neuropathy, or mononeuropathy, produces muscle weakness or pain in the head, torso, or legs. Symptoms may include eye pain, double vision, paralysis on one side of the face, or pain in the lower back, legs, chest or stomach area. However, focal neuropathy does not cause long-term damage and may improve over a period of weeks or months, according to WebMD.

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