Diabetic neuropathy, a nerve disorder, is a complication of diabetes that can lead to problems throughout the body. People with diabetes can develop nerve problems at any time, but significant clinical neuropathy can develop within the first 10 years after receiving a diabetes diagnosis. The risk of developing neuropathy increases the longer a person has diabetes. About half of people with diabetes have some form of neuropathy. Although the exact causes of diabetic neuropathy are unknown, several factors may contribute to the disorder. One is high blood glucose, which causes chemical changes in nerves and impairs the nerves’ ability to transmit signals. It can also damage blood vessels that carry oxygen and nutrients to the nerves. Diabetic neuropathy also may be caused by inherited factors; some genetic traits may make some people more susceptible to nerve disease than others. Neuropathy can affect many parts of the body. It includes the following types: Diffuse peripheral neuropathy, which affects nerves in the extremities (legs, feet, arms, and hands). Symptoms include numbness; tingling, burning, or prickling; sharp pains or cramps; extreme sensitivity to touch; loss of balance or coordination; and insensitivity to pain or temperature changes. Diffuse autonomic neuropathy, which affects nerves that serve internal organs, processes, and systems of the heart, digestive system, sexual organs, urinary tract, and sweat glands. Symptoms include incontinence, digestive problems, low blood pressure, dizziness, fainting, impaired perception of pain, hypoglycemia, and profuse sweating. Focal neuropathy, which affects a single, specific nerve and part of the body, such as the eyes, facial muscles, hearing, pelvis and lower back, thighs, and abdomen. Symptoms include pain in the thighs; severe pain in the lower back or pelvis; pain in the chest, stomach, or flank; chest or abdominal pain that mimics angina, heart attack, or appendicitis; aching behind the eyes; inability to focus the eyes; double vision; paralysis on one side of face; and hearing problems. To diagnose neuropathy, in addition to a complete medical history and physical exam, your doctor may do the following: Check muscle strength and reflexes. Check muscle sensitivity to position, vibration, temperature, and light touch. Request additional tests, such as nerve conduction studies (to check flow of electrical current through a nerve), electromyography (to determine how muscles respond to electrical impulses), ultrasound (to determine how parts of the urinary tract are functioning), and nerve biopsy (to remove a sample of nerve for examination). The goal of neuropathy treatment is to relieve pain and discomfort, as well as to prevent additional tissue damage. Treatment may include pain medications, antidepressant medications that help the brain ignore erroneous pain signals, topical creams, transcutaneous electronic nerve stimulation (TENS) therapy, hypnosis, relaxation training, biofeedback training, and acupuncture. Specific treatments may also be prescribed for complications of neuropathy, such as gastrointestinal problems, dizziness and weakness, and urinary or sexual problems.