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Neurological symptoms often develop gradually and may include: Paraesthesia : tingling or 'pins and needles' sensations, typically starting in the feet and hands Numbness : reduced sensation in the extremities, which may affect balance and coordination Burning pain : particularly in the feet, often worse at night Weakness : muscle weakness and difficulty walking Balance problems : unsteady gait and increased fall risk due to proprioceptive impairment Cognitive changes : memory problems, confusion, difficulty concentrating, and mood disturbances Haematological signs may accompany neurological symptoms and include fatigue, weakness, pallor, and shortness of breath due to megaloblastic anaemia

An anti-inflammatory diet rich in polyphenols, phytosterols, protein, dietary fiber, and unsaturated fatty acidsespecially omega-3supports immune balance and lowers thyroid autoantibodies (Rayman 2019)

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Recent pilot studies and small clinical trials in people with diabetic neuropathy found improvements in blood flow to the skin and reductions in pain, though the number of patients studied has been small and treatment plans varied (Tassone et al., 2023)