My fiancee has type 1 diabetes. She had been having some numbness in her right big toe for the past three months. She says it is always there, just feels like pins and needles. I always thought neuropathy affected both feet, not just one. Also, I thought that other toes would also be affected. I am scared for her. Is this the start of neuropathy? How can we know for sure what is going on?

This could be neuropathy. However, it is not necessarily the case that these symptoms begin to march on and involve the other digits or areas of the feet. I would use it as warning symptom to motivate improved blood sugar control. If the pins and needles continue, there are medications that will help to decrease these symptoms. Over time, they tend to go away. However, it is also true that this may be followed by decreased sensation in the area. If the magnitude of the problem is only small areas, it seems excessive to use more invasive tests, such as nerve conduction studies. Sometimes, the pins and needles respond to something as simple as improved glucose control. If the symptoms continue, please have her address this with her physician.

JTL