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If you have diabetes, chances are good that you already have some form of nerve pain or nerve damage, called diabetic neuropathy. "People with diabetes have about a 60% chance of getting neuropathy of any kind," says Dace L. Trence, MD, an endocrinologist and director of the Diabetes Care Center at the University of Washington Medical Center in Seattle. "It's probably an equal risk of getting neuropathy with type 1 and type 2 diabetes."

You may have tingling, pain, or numbness in your feet and hands -- common signs of the diabetic nerve damage called peripheral neuropathy. Or you may have damage to the nerves that send signals to your heart, stomach, bladder, or sex organs, called autonomic neuropathy. Nerve damage can also be "silent," meaning you have no symptoms at all.

Sometimes, nerve damage starts even before a person is diagnosed with diabetes, Trance says. "Even somebody with prediabetes may have neuropathy," she says. As many as 79 million Americans have prediabetes -- a condition where blood sugar levels are high, but not high enough to be diabetes -- says the American Diabetes Association (ADA). Add to that the nearly 26 million Americans who have diabetes, and you can see how common nerve pain may be.

The good news? You can do something about it. You may not be able to prevent nerve pain and damage completely, but you may be able to slow it down. You can lower your risk of nerve damage and other diabetes complications by keeping your blood sugars under tight control, says the National Diabetes Information Clearinghouse (NDIC).

Trence agrees. "The better the blood sugar control, the less likely neuropathy is to progress." A healthy lifestyle helps lower your risk of heart disease, stroke, and other diabetes complications, as well. So know your risk for complications, and work to control the ones you can control.

Are You at Risk for Diabetic Neuropathy?

1. You Have High Blood Sugar

The risk: Who are the people at highest risk of nerve pain and damage from diabetes? Those who have trouble controlling their blood sugar.

What you can do: Sometimes glucose control is about mind over matter: you may simply need a little help staying motivated, sticking to your exercise program, or learning how to prepare more varied, tasty, healthy meals. But if you're "doing everything right" and still have high glucose levels, you may need to change your plan and start or adjust medications to help better manage your blood sugars.

2. You've Had Diabetes for Many Years

The risk: Nerve pain and damage is more common in people who have had diabetes for a longer period of time.

What you can do: Do your best to monitor your blood sugar at home as often as advised by your doctor. The NDIC also advises having the A1c test, a blood test that measures your average blood glucose control over the previous 2 to 3 months, at least twice a year. Trence advises taking the A1c more often as an extra measure of control. "I think most of us believe it should be done every 3 to 4 months," she says. "It can vary, but we need to keep on top of things, and it's such a powerful piece of information to have to complement the patient's own blood sugars."

Exercises to Ease Nerve Pain

Simple moves and tips to help you avoid pain and falls.
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Know Your Nerve Pain Risk

Is your diabetes putting you at higher risk?