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This may result in sense loss, difficulty in proprioception, neuropathic pain, difficulty walking, poor balance, loss of sensation in the feet, muscle weakness, blurred vision (either due to retinopathy [27] or optic neuropathy [28] ), impaired urination, fertility problems, decreased sense of taste and smell, decreased level of consciousness, changes in reflexes, memory loss, mood swings, depression, irritability, cognitive impairment, confusion, anxiety, clumsiness, dementia, and, in more severe cases, psychosis

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And this can cause the medication to no longer work effectively, says Dr

Insulin sensitivity declines, making glucose management less efficient