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Molly Maloof, MD

Director of Clinical Content

diabetic and nubmness in toes

My toes tingle a little when I lay down or prop up my feet but it's fine when I stand or walk. I have diabeties type 2. What should I do?
  • Male | 55 years old
  • Medications: metaforman, lycenprilil
  • Conditions: Diateties overwheight and loosing

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The first step I would take is to have your Podiatrist refer you to a Neurologist for a Nerve Conduction study to see how severe your neuropathy is. I would also have your circulation checked. Sometimes, in mild cases of Diabetic Neuropathy, very tight control of your blood sugar may reduce the symptoms. There are also topical analgesic and anti-inflammatory creams that might work to alleviate your discomfort. If these conservative measures fail, there are also sever types of oral medications. But the first step would be to get a definitive diagnosis on what is causing the numbness-circulation issues or nerve related issues. You have many options once you find the diagnosis
Get your blood flow checked.
If your legs are fine when you walk, then your symptoms are not a result of poor circulation. Pain with walking precedes arterial symptoms from lack of circulation when you elevate your legs. Since you are diabetic, diabetic neuropathy is a possible diagnosis. Direct your efforts in addressing the neuropathy as opposed to the circulation.
The advice posted is all important. I agree that you likely have diabetic neuropathy. That said there are several reasons for your toes to "tingle", in your case your circulation- blood flow to your feet is my initial concern. Based on the reason why you get this feeling the prior posts address the issue: I suggest you first see your primary doctor who is treating you; you should be seen by a podiatrist for a thorough exam of your lower extremity especially your foot/ankle at which time a complete evaluation of your blood flow-circulation and nerve exam will help determine your current risk for neuropathy, poor circulation and ability to heal any ongoing or new problems that are specific to the feet.

The B vitamin recommendations are excellent, if you can Metanx has been very helpful to many of my patients, bad news is it generally not covered as it is a FDA food supplement, there is no current generic equivalent, and takes several months to work. It is for neuropathy symptoms-burning, tingling, painful feet, toes. It is important to realize that although your current "tingling" is likely related to your circulation- blood flow, there is a link between that problem and current or future nerve pain.

All other posts are very important- it falls on you to do all you can since the way you manage this now will be critical in the years to come. Be Well Be happy.
Gary S. Scheinin
You might consider some specific essential oils and supplements to improve circulation and repair the nerves. Oral chelation is very popular and done by many people in order to remove build-up in the blood-vessels.

Also, if you are type II, you can turn your life around through dietary changes.

I would be happy to help if you are interested.
Certainly get evaluated by your endocrinologist if there is ever any change in your condition, but here are a few other ideas for what sounds like diabetic neuropathy.

Alpha-Lipoic Acid - Antioxidant that is very helpful for protecting nerve funtion

Vitamin B6 + B Complex - B6 is especially indicated for the nervous system

Also, movement and weight loss (if you are overweight) -- Movement helps to support healthy circulation and weight loss takes a bit of the load off of your extremities.

Dry skin brushing is also an easy cheap home treatment to support circulation. Here is a link:
Are you seeing an endocrinologist? Also you should probably see a foot and ankle specialists to treat these symptoms. As a diabetic you will be more prone to neuropathy, ulcerations, and many other issue due to your diabetes. These issues should be taken care of by a specialist so that things do not worsen.
Mikkel Jarman
This is most likely related to diabetic neuropathy especially if it is involving the toes of both feet. However, I would suggest having a lower extremity arterial duplex examination with ABIs to exclude arterial insufficiency.
Angelo Makris
I think these could be classic symptoms of peripheral arterial disease and this should be ruled out as soon as possible. You should get an arterial brachial index to rule out this possibility. Especially if you get pain in your calves after walking a short distance, which could be related to something called claudication, I would worry about an arterial problem. If the arterial brachial index is normal, then your symptoms could be related to diabetic neuropathy. Changing your lifestyle, i.e. diet and exercise, as well as good glucose control will help with these symptoms. I would see your primary doctor as soon as possible and ask to be referred to a vascular specialist. Good luck.
It could be from your circulation instead of your nerves. Blood flow better with gravity and activity helping it. You should probably get a PADnet test done by a Podiatrist to rule out this possibilty.