Have you ever experienced pins and needles in your feet, a strange burning sensation in your toes, or numbness that seems to appear for no obvious reason?

While these sensations can have several causes, they may also be an early warning sign of something happening beneath the surface.

When we think about diabetes, blood sugar, diet and insulin usually come to mind. But did you know diabetes can also affect your nervous system?

Research suggests that up to 50% of people living with diabetes may develop diabetic peripheral neuropathy, a condition that affects how nerves communicate with the rest of the body (Pop-Busui et al., 2017). So, what’s happening, and how can you better support your nerve health?

Think of your nervous system as your body’s communication highway. Every second, messages travel between your brain, spinal cord and the rest of your body, helping you move, feel and respond to your surroundings.

When peripheral nerves become damaged, these messages can become disrupted. This is known as peripheral neuropathy.

In people living with diabetes, nerve damage commonly begins in the feet and may gradually progress up the legs.

Some signs to look out for include:

• Tingling, burning or pins and needles.
• Numbness or reduced sensation in your feet.
• Shooting pain, particularly at night.
• Muscle weakness or changes in balance.
• Difficulty noticing cuts, blisters or injuries.

Interestingly, neuropathy doesn’t always cause pain. Some people gradually lose sensation without realising anything has changed.

When blood glucose remains elevated over time, it can damage the tiny blood vessels responsible for supplying your nerves with oxygen and nutrients.

Imagine a garden hose supplying water to your plants. If the flow becomes restricted, those plants may struggle to get what they need. Something similar can happen to your nerves.

Diabetes can also contribute to inflammation, oxidative stress and changes in how nerve cells produce energy, all of which may affect nerve function (Feldman et al., 2019).

And it’s not just about blood sugar! High blood pressure, elevated cholesterol and smoking can also influence your risk.

Your feet constantly send information to your brain about the ground beneath you and where your body is positioned.

When this communication becomes less reliable, everyday activities like walking, balancing and navigating uneven surfaces can become more challenging.

Peripheral neuropathy may also affect sleep, confidence with movement and your ability to notice injuries.

That’s why recognising changes early and keeping up with regular diabetic foot assessments is so important.

The good news? While established nerve damage isn’t always reversible, there are practical steps you can take to reduce your risk of complications and support your overall health.

1. Keep your blood sugar in check. Balanced meals, regular movement and following your diabetes management plan can help maintain healthier glucose levels.

2. Move your body daily. Walking, cycling and strength exercises can support insulin sensitivity, circulation and balance. Choose activities appropriate for your foot health and mobility.

3. Give your feet some attention. Check for cuts, blisters or skin changes, wear properly fitted shoes and attend regular foot assessments.

4. Prioritise sleep and stress management. A consistent sleep routine, relaxation techniques and time for activities you enjoy can support your overall wellbeing.

5. Build your healthcare team. Your GP, podiatrist, diabetes educator and other healthcare professionals can help you manage diabetes and reduce the risk of complications.

If you’re experiencing back pain, joint stiffness or other musculoskeletal concerns, a chiropractor may also assist with assessing and managing those complaints where appropriate. Chiropractic care does not treat diabetic neuropathy or replace medical diabetes management.

Diabetes-related nerve damage can develop gradually, sometimes without obvious warning signs. But understanding what to look for and taking proactive steps can make a meaningful difference.

If you’re experiencing persistent numbness, tingling or changes in balance, speak with your GP to investigate the cause.

At Chiropractic Life, we believe that maintaining comfortable movement and mobility is an important part of living well. If musculoskeletal discomfort is affecting your everyday activities, our chiropractors can assess your concerns and discuss whether chiropractic care may be suitable for you.

Remember, looking after your health isn’t about doing everything perfectly. It’s about making small, sustainable choices that help you keep doing the things you love.

Pop-Busui, R., Boulton, A. J. M., Feldman, E. L., Bril, V., Freeman, R., Malik, R. A., Sosenko, J. M., & Ziegler, D. (2017). Diabetic neuropathy: A position statement by the American Diabetes Association. Diabetes Care, 40(1), 136–154. https://doi.org/10.2337/dc16-2042
– Supports the discussion of diabetic peripheral neuropathy prevalence, common symptoms, risk factors, early detection and the importance of blood glucose management in preventing or slowing nerve damage.

Feldman, E. L., Callaghan, B. C., Pop-Busui, R., Zochodne, D. W., Wright, D. E., Bennett, D. L., Bril, V., Russell, J. W., & Viswanathan, V. (2019). Diabetic neuropathy. Nature Reviews Disease Primers, 5, Article 41. https://doi.org/10.1038/s41572-019-0092-1
– Explains the underlying mechanisms of diabetic nerve damage, including oxidative stress, inflammation, metabolic dysfunction and impaired nerve function. Also supports the discussion of risk factors, clinical symptoms and the potential impact on mobility and quality of life.

Diabetes Australia. (n.d.). Diabetes and your feet. https://www.diabetesaustralia.com.au/living-with-diabetes/preventing-complications/foot-care/
– Provides practical guidance on diabetic foot care, including daily foot inspections, appropriate footwear, regular professional assessments and early identification of injuries to reduce the risk of complications.