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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Diabetic, Have Constant Pain On The Tip Of Toes. Nerve Ends Dying?

Hi, I have a question about the tip of my toes (this applies to the toe next to my big toe and the one next down in size), i have been experiencing pain which is not dissimilar from when you have worn shoes which are too small, but my shoes are not too small may i add and it is a constant pain when pressure is applied to them ie walking?? I have just read something about nerve ending maybe dying could this be the case?? alos i have been diabetic nearly 30 years hence why i was concerned with the nerve ending maybe dying!! Although my diabetes has been well controlled over the years, could you give me an explaination and i know this must be difficult without seeing them - also note there are no marks lumps etc
Mon, 18 Feb 2013
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General & Family Physician 's  Response
Hello,
Although  people with diabetes can develop nerve problems at any time, but risk rises with age and longer duration of diabetes. The highest rates of neuropathy are among people who have had diabetes for at least 25 years. 

The causes are probably different for different types of diabetic neuropathy.
Although the most common cause for diabetic neuropathy is uncontrolled blood sugar levels but such neuropathies can occur even with proper control of sugar levels and is due to several causes like 
long duration of diabetes, 
abnormal blood fat levels, and possibly low levels of insulin
autoimmune factors that cause inflammation in nerves
Genetic factors  that increase susceptibility to nerve disease
lifestyle factors, such as smoking or alcohol use
Thanks
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Diabetic, Have Constant Pain On The Tip Of Toes. Nerve Ends Dying?

Hello, Although  people with diabetes can develop nerve problems at any time, but risk rises with age and longer duration of diabetes. The highest rates of neuropathy are among people who have had diabetes for at least 25 years.  The causes are probably different for different types of diabetic neuropathy. Although the most common cause for diabetic neuropathy is uncontrolled blood sugar levels but such neuropathies can occur even with proper control of sugar levels and is due to several causes like  long duration of diabetes,  abnormal blood fat levels, and possibly low levels of insulin autoimmune factors that cause inflammation in nerves Genetic factors  that increase susceptibility to nerve disease lifestyle factors, such as smoking or alcohol use Thanks