Type 2 diabetes with diabetic neuropathy

Diabetic neuropathy often affects the feet and lower legs first. Symptoms can include pins and needles, burning pain, electric-shock sensations, numbness, unusual sensitivity to touch, muscle weakness, or reduced balance. Loss of feeling means a blister, burn, tight shoe, or small cut may go unnoticed. Nerve changes can also affect digestion, sweating, blood pressure, or sexual function, so mention symptoms beyond the feet.

Check both feet every day, including the soles and spaces between the toes, using a mirror if needed. Wash and dry carefully, moisturise dry skin without applying cream between toes, and wear well-fitting footwear. Test bath water with a hand rather than a numb foot, and do not cut corns or calluses yourself. Keep glucose within your agreed range and ask about treatment for painful nerve symptoms. A foot review can identify pressure points before the skin breaks.

Get prompt medical advice for a new wound, blister, colour change, swelling, warmth, discharge, or spreading redness. Urgent assessment is needed for fever with a foot wound, rapidly worsening pain, blackened skin, or sudden weakness. New loss of balance or rapidly changing sensation also deserves review. A foot infection such as cellulitis can worsen while pain is muted by numbness.

Which nerves appear affected, and what tests are needed? How often should my feet be examined? What footwear or podiatry support would help? Which pain treatments fit my kidney function and other medicines?