Nerves and Feet

High blood sugar damages nerves, and the longest nerves — those reaching your feet — are affected first. The result is numbness, tingling, burning, or pain, usually starting in the toes.

There is something specific to LADA here. Damage to the small nerve fibres, which carry temperature and pain sensation, appears to occur earlier and more severely in LADA than in Type 2 diabetes of similar duration. It is linked to how high blood sugar has run.

Small-fibre damage is easy to miss in a standard examination, so mention symptoms directly rather than waiting to be asked — burning feet at night, feet that feel hot or cold without reason, or altered sensitivity to temperature.

The danger of numbness is that injuries go unfelt. A stone in a chappal, a blister, a small cut can become a serious infection before you notice it.

• Look at your feet every day, including between the toes and the soles — use a mirror or ask someone if you cannot see them.
• Never walk barefoot. Not in the house, not on temple floors, not on hot terraces, not on sand.
• Check inside footwear with your hand before putting it on.
• Wash and dry feet daily, especially between the toes, and moisturise dry skin but not between the toes.
• Cut nails straight across, and have corns and calluses dealt with professionally rather than at home.

See a doctor the same week for any cut, blister, ulcer, colour change, swelling, or an area that is warm to touch. Foot problems in diabetes escalate quickly and treat easily when caught early.