As a diabetes educator for over 15 years, I’ve worked with thousands of patients experiencing diabetic neuropathy. One of the most common questions I hear is: “Why do my feet burn and tingle even when my blood sugar is under control?”

The answer isn’t as simple as most people think. While managing blood glucose is important, diabetic nerve pain involves multiple factors that many people aren’t aware of.

According to the National Institute of Diabetes and Digestive and Kidney Diseases, 60-70% of people with diabetes will develop some form of neuropathy. Understanding the underlying causes can help you work more effectively with your healthcare team.

What many people don’t realize: Diabetic neuropathy occurs when high blood sugar damages small blood vessels that supply nerves with oxygen and nutrients. This process, called microvascular damage, can happen gradually over years — even when A1C levels appear controlled.

Common symptoms include tingling, burning sensations, numbness, sharp pains, and loss of balance. If you’re experiencing any of these, it’s important to discuss them with your doctor as early intervention can make a significant difference.

Recent research has shown that in addition to blood sugar management, factors like proper circulation, nutritional support, and lifestyle modifications play important roles in maintaining nerve health. Some studies suggest that certain vitamin deficiencies may also contribute to nerve function issues in diabetics.

If you’re dealing with diabetic nerve pain, work with your healthcare provider to develop a comprehensive management plan. This may include medication, physical therapy, nutritional counseling, and regular monitoring.

Learn more about diabetic neuropathy management approaches and what questions to ask your doctor at your next appointment.