Diabetes is a disease, which afflicts a large percentage of our population. It is caused by the body’s inability or reduced ability to produce insulin. This in turn caused blood sugar to rise. This rise in blood sugar reduces the body’s ability to heal from wounds or injury. In addition it will affect the small and medium blood vessels and nerves of the body. These structures are in the hands, feet and eyes. Therefore diabetes can cause numbness of hands and feet. There can also be damage to the nerves and vessels of the eyes causing vision problem or even blindness. When there is lack of sensation of the feet, simple wounds can turn into severe infections without a person knowing it. This lack of sensation is known as Diabetic Peripheral Neuropathy. Diabetic Peripheral Neuropathy can also become quite painful causing a “burning” sensation of the feet.
Why do foot problems happen in diabetics?
- Elevated levels of blood sugar will cause damage to the outer layer of nerves in turn reducing nerve conduction. This will cause decrease sensation of touch, pressure and temperature. As a result of this diabetics are more susceptible to burns, frostbite and infection from undetected wounds.
- Diabetes also causes premature narrowing of blood vessels. This causes reduces blood flow to healing wounds.
- There are two different kinds of neuropathy in diabetes. The first is called Sensory neuropathy. This kind of neuropathy is responsible for the loss of sensation mentioned above. The second is called autonomic neuropathy which causes other problems such as dry skin, changes in bowel habits, urinary incontinence, erectile dysfunction and break down of the bones of the feet (Charcot Arthropathy).
Treatment
Your Podiatrist will perform a thorough history and physical examination. Included in this examination will be the evaluation of circulation (i.e. feeling pulses) and the testing of nerves (i.e. reflexes, vibration sense, and touch sense). Other tests that may be helpful in the diagnosis of foot problems will be x-ray, MRI, CT, Doppler or other non-invasive vascular testing, and nerve testing. The only truly effective treatment of diabetic foot pain is the careful control of blood sugar. There are medications that are effective at reducing the symptoms of diabetic peripheral neuropathy that can be prescribed by your Podiatrist or primary care physician.
Prevention
- Daily check of blood sugar
- Proper diabetic nutrition and diet. A nutritionist is strongly recommended to achieve this goal.
- Daily inspection of feet for signs of breaks in skin, rashes, wounds, ingrown nails.
- Properly fitting shoes. Feet change over time so you should have your feet measured when shopping for shoes.
- Do Not Walk Barefooted.
- Where clean cotton socks daily.
- Moisturize feet when dry and apply powder to heavily perspiring feet.
Some diabetics may qualify for shoe coverage by Medicare. Ask your Podiatrist if you qualify.
Call our office if you have numbness, burning of feet, your have corns calluses or blisters, you have constantly cold feet or if you have thickened or ingrown nails.
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