context: Peripheral neuropathy is nerve damage caused by chronically high blood sugar and diabetes. It leads to numbness, loss of sensation, and sometimes pain in your feet, legs, or hands. It is the most common complication of diabetes. About 60% to 70% of all people with diabetes will eventually develop peripheral neuropathy, although not all suffer pain. Yet this nerve damage is not inevitable. Studies have shown that people with diabetes can reduce their risk of developing nerve damage by keeping their blood sugar levels as close to normal as possible. What causes peripheral neuropathy? Chronically high blood sugar levels damage nerves not only in your extremities but also in other parts of your body. These damaged nerves cannot effectively carry messages between the brain and other parts of the body. This means you may not feel heat, cold, or pain in your feet, legs, or hands. If you get a cut or sore on your foot, you may not know it, which is why it's so important to inspect your feet daily. If a shoe doesn't fit properly, you could even develop a foot ulcer and not know it. The consequences can be life-threatening. An infection that won't heal because of poor blood flow causes risk for developing ulcers and can lead to amputation, even death. This nerve damage shows itself differently in each person. Some people feel tingling, then later feel pain. Other people lose the feeling in fingers and toes; they have numbness. These changes happen slowly over a period of years, so you might not even notice it. Because the changes are subtle and happen as people get older, people tend to ignore the signs of nerve damage, thinking it's just part of getting older. But there are treatments that can help slow the progression of this condition and limit the damage. Talk to your doctors about what your options are, and don't ignore the signs because with time, it can get worse. Numbness is the most common, troubling symptom of nerve damage due to diabetes. The loss of sensation is a special concern. People who lose sensation are the ones most likely to get ulcers on their feet and to end up needing amputations. People describe the early symptoms of peripheral neuropathy in many ways: Numbness Tingling Pins and needles Prickling Burning Cold Pinching Buzzing Sharp Deep stabs Others describe sharp pain, cramps, tingling, prickling, a burning sensation. Still others have exaggerated sensitivity to touch. The symptoms are often worse at night. Be on the look out for these changes in how you feel: Touch sensitivity. You may experience heightened sensitivity to touch, or a tingling or numbness in your toes, feet, legs, or hands. Muscle weakness. Chronically elevated blood sugars can also damage nerves that tell muscles how to move. This can lead to muscle weakness. You may have difficulty walking or getting up from a chair. You may have difficulty grabbing things or carrying things with your hands. Balance problems. You may feel more unsteady than usual and uncoordinated when you walk. This occurs when the body adapts to changes brought on by muscle damage. Because people with type 2 diabetes may have multiple health problems, doctors don't always diagnose peripheral neuropathy when symptoms first appear. You need to be aware that your pain may be confused with other problems. Make sure your pain is taken seriously.