Diabetic Peripheral Neuropathy: What You Need to Know

Did you know up to half of people with diabetes feel tingling, burning, or numbness in their feet? That’s diabetic peripheral neuropathy (DPN) – a nerve problem that crops up when high blood sugar damages the tiny nerves that run to your hands and feet.

It’s not just an annoying sensation. If left unchecked, DPN can lead to foot ulcers, infections, and even loss of toes. The good news is most of the damage can be slowed down or eased with the right steps.

Symptoms and Why They Happen

The first sign is often a pins‑and‑needles feeling in the toes or soles. It may progress to a constant burning, sharp stabbing pain, or outright numbness. You might notice that a small cut heals slowly or that you can’t feel a pebble in your shoe.

Why does this happen? High glucose levels over time wear down the protective coating of nerves and shrink the blood vessels that feed them. The result is poor nerve signal transmission and reduced sensation.

Other red flags include muscle weakness, loss of balance, and a feeling that your feet are larger or smaller than they actually are. If any of these pop up, it’s time to act.

Managing the Nerve Pain

The most powerful tool is tight blood‑sugar control. Even a small drop in A1C can slow nerve damage. Use your glucose meter, follow your meal plan, and keep active – a brisk 30‑minute walk most days works wonders.

Foot care is another must. Check your feet daily for cuts, blisters, or redness. Keep nails trimmed straight, wear loose‑fitting cotton socks, and choose shoes with good arch support. If you can’t see your feet well, ask a family member to help.

Medication can help when the pain gets strong. Over‑the‑counter options like acetaminophen or ibuprofen work for mild discomfort. Doctors may prescribe duloxetine, pregabalin, or gabapentin for moderate‑to‑severe pain. Always discuss side effects and dosage.

Some people find relief with supplements. Alpha‑lipoic acid, a antioxidant, has shown modest benefit in studies. Vitamin B12 deficiency can worsen neuropathy, so a B‑complex check might be worthwhile.

Physical therapy can improve balance and muscle strength, reducing falls. Simple exercises – ankle circles, toe curls, and calf raises – keep the muscles around the nerves active and improve circulation.

Quit smoking and limit alcohol. Both shrink blood vessels further and can speed up nerve damage. If you need help quitting, your doctor can point you to resources.

Finally, don’t ignore regular check‑ups. Your healthcare team can track nerve health, update treatment plans, and catch foot problems early. Early action cuts the risk of serious complications dramatically.

Living with diabetic peripheral neuropathy is a daily balancing act, but with tight sugar control, diligent foot care, and the right therapies, you can keep the pain in check and stay on your feet.