Complications

Diabetic neuropathy can cause a number of serious complications, including:

• Hypoglycemia unawareness. Blood sugar levels below 70 milligrams per deciliter (mg/dL) normally cause shakiness, sweating and a fast heartbeat. But if you have autonomic neuropathy, you may not notice these warning signs.
• Loss of a toe, foot or leg. Nerve damage can make you lose feeling in your feet, so even minor cuts can turn into sores or ulcers without your realizing it. In severe cases, an infection can spread to the bone or lead to tissue death. Removal (amputation) of a toe, foot or even the lower leg may be necessary.
• Urinary tract infections and urinary incontinence. If the nerves that control your bladder are damaged, you may be unable to fully empty your bladder. Bacteria can build up in the bladder and kidneys, causing urinary tract infections. Nerve damage can also affect your ability to feel when you need to urinate or to control the muscles that release urine, leading to leakage (incontinence).
• Sharp drops in blood pressure. Damage to the nerves that control blood flow can affect your body's ability to adjust blood pressure. This can cause a sharp drop in pressure when you stand after sitting, which may lead to dizziness and fainting.
• Digestive problems. If nerve damage strikes your digestive tract, you can have constipation or diarrhea, or both. Diabetes-related nerve damage can lead to gastroparesis, a condition in which the stomach empties too slowly or not at all, which causes bloating and indigestion.
• Sexual dysfunction. Autonomic neuropathy often damages the nerves that affect the sex organs. Men may experience erectile dysfunction. Women may have difficulty with lubrication and arousal.
• Increased or decreased sweating. Nerve damage can disrupt how your sweat glands work and make it difficult for your body to control its temperature properly.