The most common type of diabetic neuropathy is called peripheral neuropathy, which affects the nerves in the arms and legs. In people with this form of neuropathy, loss of feeling or pain is first felt in the extremities, especially in the toes, feet and hands. While less common, neuropathies in other areas of the body may also occur, so be aware of pain in the thighs, hips or any sudden muscle weakness.

Autonomic neuropathy affects the digestive system and the nerves that control blood pressure. This form of neuropathy causes problems with the bladder, bowel, sexual response and perspiration.

If neuropathy is suspected after this preliminary exam, your doctor may perform more extensive tests to determine the degree of the problem. This may include a comprehensive foot exam to assess the circulation and sensation, as well as check reflexes and test the ability to sense vibrations in the foot. A doctor may also perform a nerve conduction study or an electromyography, which test the ability for nerves and muscles to send and receive electrical signals. Ultrasound may be used to check the internal organs for signs of autonomic neuropathy.

If you have peripheral neuropathy, you may have to take special care of your feet to prevent infections from cuts and scrapes, which may occur without you realizing. Pain can be relieved with aspirin, acetaminophen (Tylenol) or nonsteroidal anti-inflammatory drug (Advil). Capsaicin, a topical cream, may also help to reduce pain. If the pain persists or worsens, your doctor may also prescribe a more potent medication.

Eating small, frequent meals low in fat and fiber may help prevent the gastrointestinal problems that may accompany autonomic neuropathy. Medications such as erythromycin or metoclopramide may be prescribed to speed digestion and reduce nausea.

If the neuropathy is causing sexual problems, there are oral drugs, vacuum pumps or an injectible drug, called a vasodilator, which can help to treat erectile dysfunction in men. Lubricants can be helpful for women.