### Understanding Diabetic Neuropathy Numbness in the feet is a symptom of neuropathy or nerve damage, one of the most common long-term complications of type 2 diabetes. Neuropathy is caused by poor blood sugar control that persists over a long period of time. The higher the blood sugars and the longer they stay high, the greater the chance of developing neuropathy. The nerves that get affected by high sugars tend to be the longest nerves in the body, which is why the feet get affected before the arms or hands. Diabetic neuropathy also tends to be bilateral, meaning both feet will be affected equally. If blood sugar remains poorly controlled, it can lead to serious complications. In the feet, diabetic neuropathy can cause numbness, pain, and injuries. It can change the shape of your feet, deforming them so they no longer fit into regular shoes. It can also dry out and damage your skin, cause calluses and ulcers on your feet, and interfere with circulation. The numbness makes it hard to tell if there is a cut or injury, increasing the risk of infections and amputation. People with diabetes are at an increased risk for amputation. In 2010, approximately 73,000 non-traumatic lower-limb amputations were performed on adults diagnosed with diabetes. The good news is that most amputations are preventable when you manage your diabetes well, take good care of your feet, and wear proper footwear. If you have circulatory problems or have already been diagnosed with neuropathy, seeing a podiatrist as well as your endocrinologist can be beneficial. If you’re concerned you may have neuropathy or if you experience any redness, cracks, pus, ulcers, or other signs of infection in your feet, it is advised to see your doctor immediately. The most effective way to prevent or delay diabetic nerve damage is to maintain good control of your blood sugar. Controlling blood pressure and cholesterol is also important. Exercise, a healthy diet, and maintaining a healthy weight are crucial for overall cardiovascular and cholesterol health. Overweight or obese patients tend to develop more neuropathy and more arthritic problems and pain in their feet because of the extra weight. Your doctor may also want to check for a vitamin B deficiency. One of the most common medications used to treat diabetes, Metformin, can cause a deficiency in folic acid and vitamin B-12 in about 10 percent of people who take it. While maintaining good blood sugar control can help prevent or delay neuropathy, there is no cure once the nerves are damaged for a long period of time. However, researchers have seen some promising results in recent studies with mice, suggesting that fish oil (specifically omega-3 fatty acids) may help reverse or slow the progression of diabetic neuropathy. Overall, earlier diagnosis, better treatments, and patients working with their doctors to take charge of the disease have led to fewer cases of neuropathy. People with diabetes are doing much better nowadays, with complications occurring less often and much later in the disease.