Question: A year or two or so ago I noticed that the middle three toes on both feet were becoming numb. My primary care physician opined that it appears to be the onset of neuropathy, but not to be alarmed. Now, the numbness has begun to spread across the feet, beginning to affect the great toes and across the bottom of the toe pads. Still, it is not especially uncomfortable and does not appear to affect my stability, although at 83 years old I am a little unstable anyway. The numbness has been remarkably symmetrical between both feet, and I have not experienced pain.

My foot numbness has not been a big deal with me or my physicians. My neurogolist thinks it might be a capillary problem and my cardiologist thinks it is neuropathy -- sort of a turf war in reverse -- but neither doctor has really diagnosed it. All in all it seems to be neuropathy, and my primary care physician has been observing it over time. The tacit consensus of my medical professionals appears to be that, at 83 and with other conditions, it's the least of my worries. I fully trust my primary and my cardiologist, but not so much my neurologist.

About five years ago I advanced from pre-diabetes to type 2 diabetes. My primary care physician prescribed three 500mg Metformin and one 2.5 Glipizide XL daily, along with diabetic training, reasonable diet, exercise, and blood-sugar monitoring. I take the meds conscientiously, but am not so rigorous about diet, exercise, and blood monitoring. On those few occasions that I do measure blood-sugar, it is always below 150 and never seems to dive down to hypoglycemia. My primary care physician and I do not feel that my diabetes is advancing very fast.

There is not a lot of diabetes in my family, and no juvenile type 1; only my mother and grandfather developed type 2 diabetes later in their lives. I also have GERD, OSA, RLS, hypertension, cholesterol, insomnia, and had five heart bypasses 8 years ago and two stents since, but I am being treated for all these issues with physicians and plenty of Rx's. All in all I am active, have these maladies under pretty good control, and feel good.

My question is about the numbness in my feet: Is neuropathy indicated? Is it likely to be associated with type 2 diabetes? Can it be remedied or slowed, or does it need to be? When should I get serious about treating diabetes? How bad can the numbness become? Will I eventually become less and less stable standing or walking? Will pain develop? How fast might all this advance? Is this the issue that sometimes leads to amputation of the feet for diabetics? Should I see another specialist, like an Endocrologist?