Numbness or Tingling

People with diabetes often experience numbness, tingling, or pain, usually in their feet, legs, hands, and arms. This is known as peripheral (sensory) neuropathy, or nerve damage. This happens because over time, high blood sugar damages nerves throughout the body.^1,2

Diabetic neuropathy is a serious complication that affects between 50 to 60 percent of people with diabetes. Some people have mild symptoms, but diabetic neuropathy can be painful and disabling for others.^1,2

Why does diabetes cause numbness and tingling?

Your peripheral nerves send information from your brain and spinal cord (central nervous system) to the rest of your body. These nerves also send sensory information – things like pain, temperature, and vibration – to your central nervous system.¹

In people with type 2 diabetes, the body is resistant to insulin. This is a hormone that helps glucose (sugar) move into cells so it can be used for energy. Eventually, the body does not make enough insulin. Since there is not enough insulin to move glucose in the cells, the extra glucose stays in the blood. This extra glucose in the blood damages nerves, as well as the small blood vessels that carry oxygen and nutrients to the nerves.³

Peripheral neuropathy can affect 1 or more nerves in different areas of the body, though it usually begins in the feet, legs, hands, and arms. The damaged nerves can cause a variety of symptoms, including:^1,4

• Numbness or tingling in the feet or hands, which often spreads to the legs and arms. Some people describe it as a “pins and needles” feeling.
• Stabbing, throbbing, or burning pain
• Sensitivity to touch or temperature
• Pain during movements or activities that normally do not cause pain, like pain in the feet when standing up
• Difficulty with coordination or falling
• Muscle weakness
• Feeling like you have socks or gloves on even when you do not

Symptoms are usually worse at night. Most people experience symptoms on both sides of the body, but they can occur only on 1 side.⁴

What should I do if I experience diabetic neuropathy?

If you experience numbness or tingling but have not been diagnosed with diabetes, you should see your doctor and discuss your symptoms. Your doctor will evaluate you to help understand what is causing your symptoms. Talk to your doctor about measuring your blood glucose to determine if it is high and whether you may have diabetes.

If you have already been diagnosed with type 2 diabetes, numbness and tingling are signs that your blood glucose is not under control. Talk to your doctor right away about your symptoms. Your doctor can help you with a treatment plan that will help control your blood glucose levels and improve your symptoms.

What can I do to protect myself against neuropathy?

There are several steps you can take to protect yourself against peripheral neuropathy. The first is to keep your blood glucose under control. If you are having trouble controlling your blood glucose, talk to your doctor.

Early detection of peripheral neuropathy is important because once nerve damage has occurred it cannot be reversed, even if your blood glucose is well managed. People with diabetes should be screened for peripheral neuropathy at least once a year. Your doctor will ask about your symptoms and medical history, and conduct a physical exam. This typically includes:⁴

• Placing a tuning fork (a type of medical instrument) on your toes and feet to check whether you can feel vibrations
• Touching your feet and toes with a nylon strand to see if you can feel it (also known as a monofilament test)
• Watching how you walk
• Testing your balance

Your doctor may also perform other tests to rule out other possible causes of nerve damage, including thyroid problems or kidney disease.⁴

Since peripheral neuropathy often reduces feeling in the feet, it can make it difficult for you to feel cuts or injuries that can lead to blisters or sores. Diabetes can make it hard for your body to heal wounds and increases your risk of infection. It is important to check your feet for problems every day and talk to your doctor if you notice any issues.^1,4

If you are diagnosed with peripheral neuropathy, your doctor may prescribe medicines to help with pain and physical therapy to improve your strength and balance.⁴