Dr. Gérald Kierzek, emergency physician and medical director of True Medical, calls for these unusual manifestations not to be trivialized. Because behind these seemingly innocuous disorders can hide diabetic neuropathy, a frequent complication of excessively high blood sugar levels for several years.
When feet become the first alarm signal
It often starts with almost nothing. A strange feeling in the evening, when going to bed. Intermittent tingling. A feeling of warmth under the soles of the feet. Then sometimes comes burning, numbness or a progressive loss of sensitivity.
Discreet symptoms, easy to minimize. However, they can be the first witnesses of a glycemic imbalance that has been present for a long time.
“Tingling, burning sensation or unusual dryness of the feet can be early signs of nerve damage linked to excess sugar sometimes before diabetes is diagnosed.explains Dr. Gérald Kierzek, emergency physician and medical director of True Medical.
When blood sugar levels remain high for months or even years, excess sugar eventually damages small blood vessels and nerve fibers. The extremities of the body — and particularly the feet — are often the first to be affected.
Little by little, the nerves transmit sensory information less well. Tingling appears. A burning sensation may occur, particularly at night. Some patients also describe a feeling of walking on cotton wool or, on the contrary, a painful hypersensitivity to the slightest contact.
The phenomenon has a name: diabetic neuropathy. And it is far from rare.
A silent complication that can disrupt everyday life
Diabetic neuropathy often sets in slowly, almost insidiously. Initially, symptoms come and go. Then they become more frequent, more intense, sometimes disabling.
Diabetes also affects the skin and blood circulation. The feet become drier and more fragile. Cracks, blisters or small sores may appear without being felt immediately, as sensitivity gradually diminishes.
“Diabetes can also make the skin drier and cause small lesions that go unnoticed because sensitivity decreases.”warns Dr. Gérald Kierzek.
This is where the risk becomes particularly concerning. A small, neglected injury can develop into an infection that is difficult to treat. In the most severe cases, these complications can lead to chronic wounds or even amputations.
However, many patients do not immediately make the connection between their feet and their blood sugar levels. Because they think of poor circulation. At age. To fatigue. Unsuitable shoes…
The doctor, however, insists on an essential point: these symptoms are not specific to diabetes. But when they appear suddenly, persist or are accompanied by other signs – unusual fatigue, excessive thirst, frequent need to urinate – they should raise alarms. And above all push to consult.
Detect earlier to avoid sometimes irreversible damage
Faced with these symptoms, the first reflex remains simple: do not wait.
A blood test generally allows you to quickly check if a glycemic disorder is to blame. Two tests are particularly used: fasting blood sugar and HbA1c, which measures the balance of sugar in the blood over several months.
At the same time, certain actions can already limit complications:
- Regularly examine your feet for redness, a crack, a blister or an area that has become numb;
- Moisturize the skin daily;
- Avoid shoes that are too tight;
- Do not walk barefoot when sensitivity decreases;
- Consult a doctor or podiatrist promptly if in doubt.
In people who already have diabetes, these symptoms must be reported immediately in order to adapt treatment and prevent worsening of nerve damage. Because the stakes are considerable: the earlier neuropathy is detected, the more it is possible to slow down its progression.
Burning or tingling feet do not always mean simple fatigue after a long day. Sometimes, they say something else: a body that discreetly tries to alert people before complications become irreversible. And in diabetes, this early listening can change an entire life trajectory.