Diabetes usually affects peripheral nerves in the feet, legs and at times, the hands. This is known as peripheral neuropathy. Diabetes also frequently affects the autonomic nervous system, giving rise to autonomic neuropathy. Initially, it affects the toes, which progresses to involve the entire foot and eventually can involve the leg. Later in the course of the disease, hands can also be involved.
Symptoms are usually worse at night and can interfere with sleep.
Numb feet are at a high risk for injury, such as accidental scalding by hot water in a footbath or accidental penetration of a foreign body, such as a small piece of gravel, into the sole of the foot. Because of lack of sensation, wounds go unnoticed, especially in between the toes and at the sole of the foot. Infection in these wounds can cause serious destruction to soft tissues and even can extend to the underlying bone. Bone infection is very difficult to treat and usually requires amputation and a prolonged course of antibiotics. The best treatment is prevention.