by Jose Banda
Question from Jose Banda:
Hi, I have neuropathic pain on one side of my body. Recently, I also feel pricking pain in my toes, especially when I wear covered shoes for a long time.
I have type 2 diabetes. My mother also had diabetes and died at age 82 after similar leg pain, weakness, amputation, and depression.
My blood sugar has been high for the last six months, moving between 14 mmol/L and 11 mmol/L. I take metformin 500 mg and glibenclamide 5 mg. What can cause this pain, and what treatment is available?
A blood sugar level of 11–14 mmol/L is about 198–252 mg/dL. If this happens often, it is high and may increase the risk of nerve damage, foot wounds, infection, and slow healing.
The pricking pain in your toes may be related to diabetic nerve pain. However, pain on one side of the body is not always typical diabetic neuropathy and should be checked by a doctor.
Please arrange a diabetes and foot review soon, especially because your sugar has stayed high for several months.
Answer by Dr. Albana Greca, MD, MMedSc
Hello Jose,
Yes. Blood glucose readings between 11 and 14 mmol/L are considered high, particularly when they occur repeatedly.
Converted to mg/dL:
The significance of these readings depends on when the test was taken, such as fasting, before a meal, or after eating. However, persistent readings within this range may indicate that blood sugar is not adequately controlled and should be discussed with a healthcare professional.
You can use this mmol/L to mg/dL blood sugar converter to check your readings.
When blood sugar remains high for months or years, it can damage nerves and small blood vessels. This may cause tingling, burning, stabbing pain, numbness, or pins-and-needles sensations in the feet.
The pricking pain in your toes, especially with covered shoes, may be due to diabetes-related foot nerve symptoms. Diabetic peripheral neuropathy commonly starts in the toes and feet.
Symptoms may include:
Pain on one side of the body should not automatically be blamed on diabetic neuropathy. Diabetic peripheral neuropathy usually affects both feet in a more symmetrical pattern, although one side may feel worse. A doctor should check for other causes such as spine nerve compression, poor circulation, shingles, vitamin B12 deficiency, or stroke warning symptoms.
Seek urgent medical help now if you have:
You mentioned metformin 500 mg and glibenclamide 5 mg. If your blood sugar has stayed between 11 and 14 mmol/L for six months, your treatment plan may need adjustment. Do not change the dose yourself. Please speak with your doctor about your HbA1c, kidney function, blood sugar diary, foot exam, and whether your medicines are still enough for you.
Glibenclamide can sometimes cause low blood sugar, especially in older adults or people with kidney problems, so medication changes should be supervised by a healthcare professional.
Better blood sugar control may help slow nerve damage. Your personal target depends on your age, other health conditions, medicines, and risk of low blood sugar. You can compare your readings with common targets here: blood sugar levels by time of day.
Look for cuts, blisters, cracks, swelling, redness, dark skin changes, calluses, or shoe pressure marks. Learn more here: diabetes and feet complications.
Use soft, well-fitting shoes with enough room for your toes. Avoid tight shoes and avoid walking barefoot if you have reduced foot sensation.
Simple painkillers often do not work well for nerve pain. Doctors may use medicines such as duloxetine, pregabalin, gabapentin, or other options depending on the patient. These need medical supervision because they may have side effects.
Your doctor may also check vitamin B12, thyroid function, kidney function, circulation, spine problems, alcohol use, medication effects, or infection.
In many cases, yes. Amputation is usually not caused by nerve pain alone. It often happens when neuropathy, poor circulation, infection, untreated wounds, and delayed care occur together.
Your mother’s experience was painful, but it does not mean the same outcome must happen to you. The most important step now is to treat the high blood sugar and foot symptoms early.
Jose, please arrange an appointment with your doctor or diabetes care team soon. Ask for a full foot check, HbA1c test, medication review, kidney function test, vitamin B12 test if appropriate, and a circulation assessment of your legs and feet.
Educational safety note: This answer is for general diabetes education only. It does not replace personal medical advice, diagnosis, or treatment from your own doctor. Do not change diabetes medication without speaking with your healthcare provider.
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