Diabetic peripheral neuropathy is a condition caused by long-term high blood sugar levels, which causes nerve damage. Some people will not have any symptoms. But for others symptoms may be debilitating.

Between 60 and 70 percent of people with diabetes have some form of neuropathy, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).

Peripheral neuropathy, the most common form of diabetic neuropathy, affects the legs, feet, toes, hands, and arms.

Many people do not know that they have diabetes. People unaware of their diabetes may not know what’s causing some of the unusual sensations they’re experiencing.

Nerve damage is the result of high levels of blood glucose over long periods of time. It isn’t entirely clear why high glucose levels damage nerves.

A number of factors may play a role in nerve fiber damage. One possible component is the intricate interplay between the blood vessels and nerves, according to the NIDDK.

Other factors include high blood pressure and cholesterol levels and nerve inflammation.

Diabetic peripheral neuropathy usually first appears in the feet and legs, and may occur in the hands and arms later.

A common symptom of diabetic peripheral neuropathy is numbness. Sometimes you may be unable to feel your feet while walking.

Other times, your hands or feet will tingle or burn. Or it may feel like you’re wearing a sock or glove when you’re not.

Sometimes you may experience sudden, sharp pains that feel like an electrical current. Other times, you may feel cramping, like when you’re grasping something like a piece of silverware.

You also may sometimes unintentionally drop items you’re holding as a result of diabetic peripheral neuropathy.

Walking with a wobbly motion or even losing your balance can result from diabetic peripheral neuropathy. Wearing orthopedic shoes often helps with this.

Loss of coordination is a common sign of diabetic peripheral neuropathy. Often, muscle weakness affects the ankle, which can affect your gait. Numbness in the feet can also contribute to loss of balance.

Your foot may begin to look injured. This is the result of unusual shifts in weight caused by walking abnormally and the loss of nerve function, which can affect the muscles.

One type of injury is called hammertoe. It occurs when one of the three toes between the big toe and the little toe becomes misshapen at the joints.

You may begin to notice sores or blisters on your feet that you can’t explain. It could be that you hurt yourself and didn’t feel it at the time.

Sometimes you don’t feel pain or injury because of the nerve damage. This can be very dangerous. For example, you could scald yourself with hot water because you’re unable to feel a pain response to heat.

Diabetic peripheral neuropathy can also result in exaggerated sensations. Holding a cup of warm coffee may feel painfully hot. It may also hurt when a person with cold hands touches you. And your hands or feet may feel hot or cold for no apparent reason.

Diabetic peripheral neuropathy often worsens at night. You may hurt so much that even a bed sheet feels very heavy and painful. This can make it difficult to fall asleep or sleep through the night.

You should be able to manage your condition by working with your healthcare provider and taking the proper medication.

Limit alcohol and avoid tobacco if you have diabetic peripheral neuropathy. These substances may worsen symptoms.

Good nutrition is important, as vitamin deficiencies can exacerbate the condition. Those on metformin should talk to their doctor about a vitamin B-12 supplement.

Unchecked wounds can potentially lead to infections that can sometimes spread to the bones. And infection in the bones can lead to amputation of feet and toes.

Make sure you see your doctor regularly and immediately attend to any sores you notice.