How Diabetes Starts Affecting Your Nerves
Diabetic Neuropathy: What It Is and When to Get Checked
If you have diabetes and you've noticed tingling, numbness, or burning in your feet, you may be dealing with diabetic neuropathy, nerve damage caused by prolonged high blood sugar. According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), up to half of people with diabetes develop some form of peripheral neuropathy, making it one of the most common complications of the disease.
Diabetic neuropathy takes several different forms. It can affect the nerves in your feet and legs, the nerves that control your heart rate and digestion, or, less often, a single nerve in your hip, thigh, or hand. The symptoms and the risks are different depending on which nerves are involved, which is why an accurate diagnosis needs to come before treatment starts.
At Peripheral Neuropathy Specialists, Dr. Mark A. Matey treats diabetic neuropathy as part of a bigger picture, checking for related vascular and circulation issues instead of treating nerve pain in isolation.
Know When It's Time
When to See a Provider About Diabetic Neuropathy
Diabetic neuropathy often starts quietly. The first signs are usually mild: tingling or a "pins and needles" feeling in your toes, occasional numbness, or a burning sensation that tends to be worse at night. Because these symptoms build slowly, it's common to dismiss them for months, or longer, before mentioning them to a doctor.
You should schedule an evaluation if you notice any of the following:
- Numbness or reduced feeling in your feet, especially if you've stopped noticing small cuts, blisters, or sores
- Ongoing tingling, burning, or sharp pain in your feet or legs
- Muscle weakness or a change in how your foot is shaped
- Dizziness or lightheadedness when standing, which can signal autonomic nerve involvement
- Digestive changes such as nausea, bloating, or feeling full quickly after eating
The American Diabetes Association(opens in a new tab) recommends that everyone with diabetes get a comprehensive foot exam at least once a year, including a check of feeling in the feet, even if nothing feels wrong. Nerve damage can be present well before symptoms show up, which is exactly why routine screening catches it before a problem develops
What Treatment Looks Like
How Diabetic Neuropathy Is Typically Treated
There's no single treatment that reverses diabetic nerve damage, but a combination of approaches can slow it down, ease symptoms, and protect against complications.
- Blood sugar management comes first. Consistently keeping blood sugar in a healthy range is the most effective way to prevent diabetic neuropathy from getting worse. That means working with your primary care doctor or endocrinologist on your overall diabetes management, alongside any nerve-specific care.
- Diagnosis before treatment. At Peripheral Neuropathy Specialists, every new patient starts with a free consultation and diagnostic evaluation. Because circulation problems and diabetes often occur together, this workup also checks for an underlying vascular or venous cause contributing to your symptoms. If one is found, venous and vascular screening can help clarify next steps before starting a nerve-specific treatment plan.
- Nerve-specific treatment. When a treatment protocol is the right next step, our neuropathy treatment program uses the Neurogenx NervePro 2.0 system, Aspen Pinnacle Laser, and Extracorporeal Shockwave Therapy. Most of this treatment is billed through insurance, with mostly no out-of-pocket cost.
- Daily foot care matters just as much as any in-office treatment. Checking your feet every day for cuts, blisters, redness, or swelling, wearing properly fitted shoes, and never walking barefoot are simple habits that catch problems early, before they become serious.
Why Early Care Matters
What Happens If Diabetic Neuropathy Goes Untreated
Nerve damage itself is rarely dangerous, but the loss of feeling it causes can be. When you can't feel a cut, blister, or pressure sore on your foot, small problems can turn into serious ones before you notice.
Left unaddressed, diabetic neuropathy can lead to:
- Foot ulcers and infections. The Centers for Disease Control and Prevention(opens in a new tab) reports that about 12% of people with diabetes will develop a foot ulcer at some point in their lives.
- Charcot foot, a condition where repeated, unnoticed injury weakens the bones in the foot, sometimes leading to visible deformity. It often starts with a foot that looks warm, red, and swollen, sometimes without much pain, which is part of what makes it easy to miss.
- Amputation risk. The CDC reports that diabetes-related lower-limb amputations occur in roughly 5 out of every 1,000 adults with diagnosed diabetes, and once someone has had one amputation, there's a real risk of needing a second within a few years.
None of this is meant to alarm you. It's meant to explain why a numb or tingling foot deserves real attention rather than a wait-and-see approach. Catching diabetic neuropathy early, before an injury happens, is what prevents these complications.
Backed by Real Data
Why We Take Diabetic Neuropathy Seriously
Diabetic neuropathy is common and serious. The American Diabetes Association(opens in a new tab) reports that more than half of people with type 2 diabetes will develop signs of diabetic peripheral neuropathy at some point in their lives, and the American Podiatric Medical Association(opens in a new tab) notes that including a podiatrist in your diabetes care can meaningfully lower the risk of amputation.
Frequently Asked Questions
The earliest signs are usually mild tingling, numbness, or a burning feeling in your toes or feet, often described as "pins and needles." These symptoms typically start small and worsen gradually, which is why routine foot exams matter even before you notice a problem. Other early signs can include increased sensitivity to touch, muscle weakness or loss of balance, and sharp, burning pain that's worse at night.
In most cases, existing nerve damage from diabetic neuropathy cannot be fully reversed, but it can be slowed, and symptoms can often be significantly improved. Consistent blood sugar management is the most effective way to prevent further damage, and nerve-specific treatment can reduce pain and improve day-to-day function for many patients. Anyone who promises a full reversal of long-standing nerve damage isn't giving you the full picture.
Diagnosis typically starts with a physical exam checking your ability to feel light touch, vibration, and temperature changes, along with a review of your diabetes history and blood sugar control. The American Diabetes Association recommends this kind of comprehensive foot and nerve exam at least once a year for everyone with diabetes. At Peripheral Neuropathy Specialists, this starts with a free consultation and diagnostic evaluation that also checks for underlying vascular or circulation problems, since these frequently occur alongside diabetic neuropathy.
For most people, walking does not make diabetic neuropathy worse, and staying active is part of standard diabetes management. The exception is if you already have a foot ulcer, sore, or injury; in that case, reducing pressure on the area is important. If you have numbness in your feet, check them before and after activity, and wear well-fitted, supportive shoes to avoid unnoticed injury.