Can tingling feet be a sign of diabetes? What to check, and where surgery fits

November is National Diabetes Month, and World Diabetes Day is November 14.^[6,7] It is a good time to ask a question many people type late at night: can tingling feet be a sign of diabetes? The short answer is yes. Here is what that tingling can mean, what to check, and where a Foot and Ankle Surgeon who treats nerves fits in.

Can tingling feet be a sign of diabetes?

Yes. Diabetes is the most common cause of peripheral neuropathy, which is damage to the nerves outside the brain and spinal cord. It usually starts in the toes of both feet and slowly moves up. People feel tingling, pain or numbness.^[8]

Many people have diabetes and don’t know it. About 40.1 million people in the US have diabetes, and 11.0 million adults with diabetes have not been diagnosed.^[9] So tingling feet are sometimes the first clue.

The American Diabetes Association recommends checking for neuropathy starting at the diagnosis of type 2 diabetes, and at least yearly after that. It also notes that up to half of people with diabetic neuropathy may have no symptoms at all.^[10] Tingling is a reason to be checked. No tingling is not proof that your nerves are fine.

Where surgery fits for people with diabetes and tingling feet

Nerve pain from neuropathy is usually treated first with medicine, but pain often persists despite it.^[8] And some people have a second problem on top of it: a nerve trapped in a tight tunnel. Surgery can treat that part.

• Trapped nerves are more common with diabetes. At the tarsal tunnel behind the inner ankle, signs of a trapped tibial nerve were found in 44.9% of people with diabetes, versus 26.5% of people without diabetes. Those nerves caused more symptoms and less feeling.^[4]
• Decompression can lower pain. In a randomized trial of 42 people with painful diabetic neuropathy, surgeons released the nerves in one leg. At one year, pain in that leg fell from 6.1 to 3.5 out of 10, versus 5.3 in the other leg, and 73.7% improved. The authors support surgery when signs of a trapped nerve are present and pain medicine falls short.^[5]
• Results can last. In a trial of 78 people with painful diabetic neuropathy who had failed a year of medical treatment, those who had surgery reported much lower pain than those who were only watched, at one year and again at about four and a half years.^[11]

Dr. Efe Ozturk, a double board certified Foot and Ankle Surgeon and podiatrist, checks for these trapped nerves. He taps along each tunnel, maps feeling in each nerve’s area and tests strength. Nerve studies and imaging, when needed, are arranged with another specialist. If a trapped nerve is found, nerve decompression may be an option. Our deeper look at the trials is in nerve decompression surgery for diabetic neuropathy.

That is why we encourage an early visit when tingling won’t settle.

Can nerve damage start before diabetes is diagnosed?

It can. Prediabetes means blood sugar is higher than normal but not yet in the diabetes range. About 115.2 million US adults have it.^[9]

• In the German study above, nerve damage was found in 13.0% of people with impaired glucose tolerance and 11.3% of people with impaired fasting glucose. Both are forms of prediabetes. The rate was 7.4% with normal blood sugar.^[1]
• A 2025 review of many studies found a clear link between prediabetes and nerve damage on several kinds of tests.^[12]
• In older adults, 140 of 154 people with nerve damage in their feet didn’t know they had it. The highest rate, 23.9%, was in people with both forms of prediabetes.^[13]

Can burning feet be a sign of diabetes?

Yes. Burning is a type of nerve pain. In the same German population, nerve pain was found in 13.3% of people with diabetes and 8.7% of people with impaired glucose tolerance, versus 1.2% of people with normal blood sugar.^[14] Read more about burning feet.

What should you check if your feet tingle?

Blood sugar. An A1C of 6.5% or higher, or a fasting blood sugar of 126 mg/dL or higher, points to diabetes. An A1C of 5.7% to 6.4%, or a fasting sugar of 100 to 125 mg/dL, points to prediabetes.^[2]

Other blood tests. A JAMA review advises a blood count, a metabolic panel, vitamin B12, a test for abnormal blood proteins (serum protein electrophoresis with immunofixation), fasting glucose and a glucose tolerance test when the cause isn’t known.^[3] The ADA adds that B12 matters most in people who take metformin for a long time.^[10]

A foot exam. A quick touch test with a thin nylon thread is part of it. See the monofilament test. Our main practice shows how to do the diabetes daily foot check (external site).

What else causes tingling feet?

Diabetes is common, but it is not the only cause. There are more than 200. They include inherited nerve conditions, some chemotherapy and heart drugs, alcohol, low vitamin B12 and abnormal blood proteins.^[8] The ADA calls diabetic neuropathy a diagnosis of exclusion, meaning other causes should be ruled out first.^[10] Learn about vitamin B12 and neuropathy and other causes of numbness, tingling and burning foot pain.

A pinched nerve can cause tingling too, often in one part of one foot. Unusual patterns, such as symptoms much worse on one side, deserve a closer look.^[3] See tarsal tunnel syndrome.

What are the limits?

The evidence for decompression is real but not settled. In the sham-controlled trial, legs that had a fake operation improved as much as released legs at one year, and the authors said a placebo effect may explain part or all of the benefit.^[11] A 2026 review of seven trials found high risk of bias, wound problems in 23.9% of surgical patients, and no trial evidence of better feeling or ulcer healing. It called the surgery investigational.^[15] The international diabetic foot guideline suggests not using decompression to prevent foot ulcers.^[16] The two Augsburg prevalence studies used a screening score in 393 people.^[1,14]

Common questions

Can foot pain be a sign of diabetes?

It can, when the pain comes with tingling or numbness, which points to nerves.^[8] Other foot pain has many causes, so an exam sorts it out.

Can prediabetes cause tingling feet?

Nerve damage is more common in prediabetes than with normal blood sugar.^[1,12] Finding it early is a reason to act on your blood sugar now.

Should I get tested for diabetes if my feet tingle?

It is a good idea. NIDDK says anyone with symptoms of diabetes should be tested, and so should people without symptoms who have risk factors.^[2] Ask your primary care doctor about an A1C or fasting blood sugar.

When to see a specialist

Book a nerve evaluation if your feet tingle, burn or feel numb for more than a few weeks, if one foot is worse than the other, or if tingling started around a diabetes or prediabetes diagnosis. We see patients in Lyndhurst, Paramus and Millburn. Please call our office at 908-215-5953 to inquire about your insurance.