Other Conditions

Diabetic Neuropathy

Do you have diabetes and feel tingling or numbness in your feet? If so, you may have diabetic neuropathy.

While many people know that diabetes affects blood sugar levels, it may also cause nerve damage in a pattern that first affects the hands and feet. This damage to the nervous system is called diabetic neuropathy, and it can have direct consequences on your feet.

Symptoms of diabetic neuropathy may not appear until many years after your diabetes is diagnosed. High blood sugar levels—also called hyperglycemia—can injure the walls of the blood vessels that nourish your nerves and result in nerve damage. That’s why controlling your blood sugar levels with the right medication, diet, and exercise is essential in helping prevent diabetic neuropathy.

Nerve damage may result in painful tingling or burning sensations in your feet and legs. But even worse is when you experience decreased protective sensation in your feet—a condition called "peripheral neuropathy" where you become unaware of pressure, pain, heat, and cold. For example, if you develop calluses, fissures, and wounds in your feet without noticing them, your risk of foot and leg infections increases.

In addition, motor nerves—the nerves that control your muscles—can be affected as diabetic neuropathy progresses. Combined with the decreased protective sensation, repetitive microtrauma (a series of small, unnoticed injuries) may result in joint damage to your feet and worsen over time. In severe cases, this condition may even lead to foot deformity, which is called Charcot neuroarthropathy.

Think You Might Have Diabetic Neuropathy?

Have I experienced electric shock-like sensations in my feet?
Have I had diabetes for many years, but failed to diagnose it?
Have I had diabetes for many years, but did not manage my diet, exercise properly, or take my medication?

If you’ve experienced electric shock-like sensations while answering yes to at least one of the other questions, your condition may have progressed into diabetic neuropathy.

Are There Any Serious Concerns with Diabetic Neuropathy?

Diabetic neuropathy can affect more than just your feet. It can also strike your autonomic nervous system—the nerves that control heart rate, digestion, and other essential functions—and lead to significant resting tachycardia (a heart rate that is higher than normal when you are at rest), slowing of the digestive system, and erectile dysfunction. Increased blood flow (or hyperemia) is also thought to contribute to foot deformity. This hyperemia leads to an increase in bone resorption (the breaking down of your bones) which can result in bony destruction and high rates of infection that may require amputation.

Treatment and Prevention

Keeping a tight control on blood sugar levels is the first defense against the symptoms of diabetic neuropathy. Follow your doctor's advice on managing your diabetes through diet, exercise, lifestyle changes, and medication.

If you have diabetic neuropathy, your doctor may prescribe medications including antidepressants, anticonvulsants, or narcotics to help with the symptoms. The results can be unpredictable—some patients find relief and others experience little or no effect. These medications can also produce strong side effects, most commonly involving sedation.