I bet it is gout! I don't have diabetes and I have the same symptoms. A very sharp, burning pain that is so intense that it wakes you from your sleep. Feels like needles sticking in your toe or foot. Those are symptoms of "gout" which comes from high uric acid levels in the body. The uric acid crystalizes in the shape of tiny needles. Unfortunately they crystalize in the joints and cause incredible pain. A blood test for uric acid levels is a good start. Of course going to a specialist is best as they can draw a sample from the toe and look at it to see if there are actually uric acid crystals. Gout can be genetic but also it can be caused by eating foods high in purine. Purine breaks down into uric acid. Avoid eating: Mussels, Herring, Yeast, Sardines
Foods moderately high in purines: Anchovies, Liver, Bacon, Salmon, Turkey, Scallops, Kidneys, Goose, Haddock
Also beer and spirits have high purine levels: HOWEVER wine does not!
Treatment:
non-steroidal anti-inflammatory drugs (NSAIDS), colchicine, corticosteroids, adrenocorticotropic hormone (ACTH) allopurinol, probenecid, sulfinpyrazone, Uloric (febuxostat), Krystexxa (pegloticase)
Many sites dedicated to gout mention that diabetics are prone to getting it.
I had this happen on and off for several years, it was sooo painful. I mentioned it to my neighbor and she told me that her husband had found relief by taking water soluble Vit. B12, -hydrocobalamine. The tablets are pink and you put it under your tongue to dissolve. The dose is a megadose, ,many times the minimum daily requirement, like 35,000x the MDR. I got my at the health food store. It totally cured my burning foot stabs in about a week and took a tablet 1x per day for 7+ yrs. Now only take it a few times per week. Have never had another episode since!! Last year my husband started having the same foot stabs (which I've since learned are for me a form of Restless Leg Syndrome and connected to being of French-Canadian heritage. Also folks with Icelandic heritage seem to have it too.) He took some of my pills and it stopped all pains within a day or two.
I have been feeling a slow steady throbbing pain in my feet by the arch and ankle. I also have diabetes and swelling of the feet and legs. I need to get some sleep but I can't find any relief. Please help.
Check your uric acid level to rule out GOUT (common in diabetes).
It can also be diabetes related peripheral neuropathy which can be improved by taking B12 Supplementation.