Burning From the Stomach to the Feet With Type 2 Diabetes

by Ramu
(India)




Quick Answer
A burning sensation from the abdomen down to the feet is not the usual pattern of diabetic peripheral neuropathy, which generally begins in the feet and often affects both sides. Diabetes-related nerve damage is possible, but spinal or nerve compression, vitamin B12 deficiency, thyroid or kidney disease, medication effects and other neurological conditions should also be considered. Arrange a prompt medical examination. Do not soak the feet in hydrogen peroxide or very warm water.


Answer by Dr. Albana Greca, MD, MMedSc



Hi Ramu,



Burning, tingling, electric-shock sensations and numbness can occur with diabetic neuropathy. However, symptoms extending from the stomach or lower abdomen to the feet are broader than the usual “stocking” pattern of diabetic peripheral neuropathy and need an examination rather than an online diagnosis.



Could This Be Diabetic Neuropathy?



It is possible, even at age 28. Young age does not exclude nerve damage, and apparently normal current glucose readings do not show what glucose control was like over previous months or years.



Typical diabetic peripheral neuropathy usually starts in the toes or feet, often on both sides, and may gradually move upward. It can cause burning, tingling, numbness, altered temperature sensation, pain or weakness.



Read more about diabetic peripheral neuropathy.




Important correction: Neuropathy is not caused because the nerves are failing to receive glucose as energy. Diabetes can damage nerves and the small blood vessels that nourish them over time.


Other Causes That Need to Be Considered




  • Spinal or nerve compression: A back problem, pinched nerve or spinal-cord disorder may cause burning below a particular level.

  • Vitamin B12 deficiency: This is especially relevant with long-term metformin use.

  • Thyroid, kidney or liver disease: These conditions may contribute to nerve symptoms.

  • Medication, alcohol or supplement effects: Bring a complete list of everything you take.

  • Other neurological conditions: An unusual, one-sided, rapidly progressive or widespread pattern may require neurology assessment.



Diabetic neuropathy is a diagnosis of exclusion, meaning other treatable causes should be checked before diabetes is assumed to be the explanation.



What Examination and Tests May Help?



Arrange an appointment with your doctor soon. The clinician may assess strength, reflexes, balance, sensation, foot pulses, skin condition and whether the symptoms follow a specific nerve or spinal pattern.



Depending on the findings, testing may include:




  • HbA1c and review of home glucose patterns;

  • vitamin B12, especially if you use metformin;

  • kidney function, thyroid testing and a blood count;

  • medicine and supplement review;

  • nerve-conduction studies, imaging or neurology referral if the pattern is atypical.



Our guide to blood tests for diabetes explains how glucose control is assessed.



How Is Neuropathic Burning Treated?



Treatment depends on the cause. If diabetic neuropathy is confirmed, improving glucose, blood pressure, cholesterol, weight and smoking status may help slow further damage, but established nerve loss is not reliably reversed.



When burning is painful or disrupts sleep, a clinician may consider medicines such as gabapentin or pregabalin, duloxetine or another serotonin-norepinephrine reuptake inhibitor, selected tricyclic antidepressants, or certain sodium-channel blockers. The choice depends on kidney function, other medicines and possible side effects.



See our overview of diabetic neuropathy treatment.



Do Not Use a Hydrogen Peroxide Foot Bath



Do not soak diabetic feet in hydrogen peroxide. It does not oxygenate nerves or treat neuropathy, and soaking can dry or damage the skin. Reduced sensation can also make burns or irritation easier to miss.



Wash the feet briefly with mild soap and warm—not hot—water, dry carefully, inspect them daily and use properly fitting footwear. Follow our daily diabetic foot-care routine.




Seek urgent care for new leg weakness, difficulty walking, loss of bladder or bowel control, numbness around the groin, rapidly spreading numbness, severe back pain, fever, a new foot wound, or a red, hot or swollen foot.


Should You Exercise?



Regular activity is useful for diabetes, but do not assume that walking will treat unexplained burning. If you have weakness, balance problems, a foot injury or symptoms made worse by movement, obtain medical advice before continuing high-impact exercise.



When it is safe, choose well-fitting footwear, check the feet before and after activity and increase exercise gradually.



My Advice



Your symptoms may involve nerves, but the distribution from the abdomen to the feet is not typical enough to diagnose diabetic peripheral neuropathy without an examination. Arrange a prompt review and bring your glucose records, HbA1c result and complete medicine and supplement list.



Until then, protect the feet, avoid peroxide or hot-water soaking, and seek urgent care if weakness, bladder or bowel changes, walking difficulty or a foot wound develops.



Hope this helps.



Dr. Albana Greca



Related Questions





Related Resources





References






Educational only — not personal medical advice. Burning from the abdomen to the feet is an atypical pattern that requires clinical assessment. Sudden weakness, bladder or bowel changes, walking difficulty or a foot wound requires urgent care.


Click here to post comments or follow up

Ask the Doctor now? Simply click here to return to Complications from diabetes.