By Dr. Moxit Shah, DM Endocrinologist
Vishuddha Endocrine Clinic, Ahmedabad
Tingling toes. Burning feet at night. A feeling of walking on cotton.
These are common early signs of Diabetic Neuropathy, nerve damage caused by long-term high blood sugar. It is one of the most frequent complications of Diabetes, and one of the most under-recognised.
The good news: early detection and good care can prevent its most serious consequences, including foot ulcers and amputations.
What is Diabetic Neuropathy?
Over time, high blood glucose damages nerves and the small blood vessels that feed them. The longest nerves, those reaching the feet, are usually affected first.
The most common type, peripheral neuropathy, starts in the toes and feet and can slowly move upwards. Other types can affect digestion, the bladder, heart rate, blood pressure and sexual function.
What are the symptoms of Diabetic Neuropathy?
- Tingling or “pins and needles” in the feet
- Burning pain, often worse at night
- Numbness, or reduced feeling of heat, cold or pain
- Sharp, shooting or electric-shock pains
- Feeling as if wearing socks when you are not
- Poor balance
Many patients say:
“My feet burn so much I can’t sleep.”
Others have no pain at all, only numbness. Painless numbness is actually more dangerous, because injuries go unnoticed.
Why is numbness in the feet dangerous?
If you cannot feel a stone in your shoe, a blister or a burn from hot sand or a heater, a small wound can become an ulcer and then an infection.
This is why daily foot care matters. See our guide to diabetic foot ulcer prevention.
Who is at higher risk?
- Long duration of Diabetes
- High HbA1c over many years
- Smoking
- High blood pressure and cholesterol
- Alcohol use
- Kidney disease
- Low Vitamin B12
How is Diabetic Neuropathy diagnosed?
The ADA Standards of Care recommend screening for neuropathy at diagnosis of Type 2 Diabetes, five years after diagnosis of Type 1 Diabetes, and at least once a year after that.
Simple clinic tests include:
- Monofilament test for protective sensation
- Vibration sense with a tuning fork
- Temperature and pinprick sensation
- Ankle reflexes
- Inspection of the feet
Other causes of similar symptoms should also be checked, especially Vitamin B12 Deficiency (more common with long-term Metformin), Hypothyroidism, kidney disease and alcohol.
Read more about Metformin and Vitamin B12.
Can Diabetic Neuropathy be reversed?
Established nerve damage is usually not fully reversible. But good glucose control, especially early on, can slow or prevent progression, and symptoms can be managed.
Be cautious of products that promise to “cure” neuropathy.
How is neuropathy pain treated?
Several medicines can reduce nerve pain, including Pregabalin, Duloxetine and Gabapentin. The choice depends on your other conditions, kidney function and side effects such as drowsiness or dizziness.
Pain relief usually improves symptoms rather than removing them completely, and doses are adjusted gradually.
What can I do at home?
- Check your feet every day, including between the toes. Use a mirror or ask a family member
- Never walk barefoot, even at home or in temples, when possible
- Wear well-fitting, closed footwear with socks
- Check bath water with your elbow, not your feet
- Keep feet clean, dry and moisturised, but not between the toes
- Cut nails straight across, or have them trimmed
- Stop smoking
- Keep blood sugar, blood pressure and cholesterol on target
When should you see a doctor urgently?
- A wound, blister or crack that is not healing
- Redness, swelling or warmth in the foot
- Discharge or a bad smell
- A change in the shape of the foot
- Fever with a foot wound
Regular checks prevent problems. See why people with Diabetes need regular eye, foot and kidney checkups.
Diabetes care in Ahmedabad
At Vishuddha Endocrine Clinic, Dr. Moxit Shah includes foot sensation screening, B12 assessment and neuropathy pain management as part of complete Diabetes care.
Frequently Asked Questions About Diabetic Neuropathy
Why do my feet burn at night?
Neuropathy pain is often worse at rest and at night. Other causes, such as B12 Deficiency, should also be checked.
Can Vitamin B12 tablets cure neuropathy?
They help if B12 is low. They do not reverse neuropathy caused by Diabetes itself.
Is walking good for Diabetic Neuropathy?
Usually yes, with proper footwear and daily foot checks. Ask your doctor if you have foot wounds or deformity.
Can I use a hot water bag on my feet?
Avoid it. Reduced sensation means you can burn your skin without noticing.
How often should my feet be checked?
By you, daily. By your doctor, at least once a year, and more often if you already have neuropathy.
Final Takeaway
Diabetic Neuropathy is common, but its worst outcomes are preventable.
Good sugar control + yearly foot screening + B12 check + daily foot inspection + proper footwear + no smoking + early treatment of wounds.
If you have tingling, burning or numbness in your feet, consult an endocrinologist early.
Dr. Moxit Shah
DM Endocrinologist
Vishuddha Endocrine Clinic, Ahmedabad
📞 +91 99799 92797
📍 Elite Magnum, Bhuyangdev Cross Road, Ahmedabad
🌐 endocrinologistinahmedabad.com
This article is for educational purposes only and does not replace an individual medical consultation. Prescription medicines should be started, adjusted or stopped only under the supervision of a qualified healthcare professional.
