Diabetic neuropathy is a type of nerve damage caused by diabetes. The most common symptoms are tingling, numbness, or pain in the hands, arms, feet, and legs. But there are other less common types of diabetic neuropathy, and a new study has found that two rare types of the condition are on the rise in the United States.
These two types are small fiber neuropathy and autonomic neuropathy. Both occur when diabetes damages the small blood vessels that supply the nerves. When that happens, the nerves can begin to die for lack of oxygen and nutrients. In small fiber neuropathy, the damaged nerves are the ones that control sensations of pain and temperature. People who have it often feel pain in their feet — a pain that eventually moves up their legs or develops in their hands. Autonomic neuropathy commonly affects involuntary body functions such as digestion, sexual function, urination, and sweat. It also affects blood pressure, which means that its most common symptom is lightheadedness, especially when standing up. According to Divpreet Kaur, MD, a neurologist at Penn State Health Milton S. Hershey Medical Center, “The blood pressure drops so much when they stand up that they feel like they are going to pass out.”
The problem with these two neuropathies is that because they are uncommon, people don’t know about them or aren’t able to recognize the symptoms. Dr. Kaur explains that not everyone with these symptoms necessarily has diabetic neuropathy, but anyone with diabetes or prediabetes who does experience them should tell his or her doctor. Once other causes have been ruled out, patients “can be referred to the neuromuscular clinic for consultation or to the autonomic laboratory for further testing.”