Insulin is released into the blood by beta cells (β-cells), found in the islets of Langerhans in the pancreas, in response to rising levels of blood glucose, typically after eating. Insulin is used by about two-thirds of the body's cells to absorb glucose from the blood for use as fuel, for conversion to other needed molecules, or for storage. Lower glucose levels result in decreased insulin release from the beta cells and in the breakdown of glycogen to glucose. This process is mainly controlled by the hormone glucagon, which acts in the opposite manner to insulin.[61]
Be sure to choose a trusted physical therapist who understands neuropathy, diabetic or otherwise, to help you work through physical therapy methods in order to prevent further nerve damage. Proper attention to physical activity by an expert can prevent any further issues from occurring. Also keep in mind that physical therapy can soothe diabetic nerve pain, but not cure it.
If possible, find a pain center that your insurance will pay for. Pain centers should combine physical, mental, and medical approaches and provide support from both professionals and other people living with pain. Some have brief residential programs followed by outpatient services. Most are entirely outpatient, and appointments are scheduled for several times a week at first, until a person’s pain is controlled adequately. A pain center may provide physical therapy, counseling, medication, self-management training, and more.

Surveys of people with diabetes report rates of chronic pain anywhere from 20% to over 60% — much higher than rates in the general population. The types of pain most often reported by people with diabetes include back pain and neuropathy pain in the feet or hands. (Peripheral neuropathy, or nerve damage in the feet and hands, is a common complication of diabetes.) Headaches and other pain sites are also frequently reported. Many people with diabetes also have arthritis, fibromyalgia (an arthritis-related illness that causes widespread muscle and joint pain and fatigue), or other painful conditions.
Abnormal cholesterol and triglyceride levels. If you have low levels of high-density lipoprotein (HDL), or "good," cholesterol, your risk of type 2 diabetes is higher. Triglycerides are another type of fat carried in the blood. People with high levels of triglycerides have an increased risk of type 2 diabetes. Your doctor can let you know what your cholesterol and triglyceride levels are.
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