When is being too sweet a problem? When you're diabetic! Diabetes and foot care go hand in hand. Often diabetics are at an increased risk of complications with their feet, usually because of a condition call neuropathy which is when the nerves in the feet are compromised and loose function, decreasing the ability to feel pain or touch. This can cause problems to arise from rubbing, calluses, blisters, and wounds. These complications can go unnoticed causing infections and even lead to amputation. Diabetics that have undergone below knee amputation have been shown to have increased risk of early mortality.
Complications from neuropathy include loss of sensation, pins and needles sensation, pain, and even a rare condition known as Charcot foot. With Charcot foot, the bones & joints of the foot may spontaneously break down, often requiring surgical intervention to rebuild a functional foot. Neuropathic pain can range from a mild irritation to intense burning pain even causing problems sleeping due to the pain. Neuropathy can be dangerous for diabetics because wounds can develop and not be noticed without regular foot inspections. Items can be in shoes and a person with profound neuropathy may not even notice it when they put their shoes on, like a tack, toy cars, or other various items that have been found in patient's shoes.
If a diabetic does develop a wound they often won't notice it due to lack of sensation which increases the risk for soft tissue infection and bone infection. These wounds are also often hard to heal because of complications from diabetes. High blood sugars make wounds difficult to heal and can contribute to an increased risk of infection. Neuropathy may delay wound healing due to loss of protective sensation where one no longer protects the foot in response to painful stimuli because of numbness.
High Blood Sugar
Chronically high blood sugars will contribute to a worsening of all the symptoms of neuropathy, and increase oxygen tension and compromise circulation in the small capillaries of the feet and toes. Regularly checking blood sugar, and faithful use of diabetic medications is important in maintaining a healthy blood sugar level.
Daily foot inspections are critical for people that have diabetes or neuropathy. It is essential to have well fitting shoe gear to prevent rubbing and blisters as well as to accommodate for common deformities such as hammertoes, bunions, or just wide feet. Early detection and access to treatment will usually minimize the damage done, and improve the chances of healing any problems before they require intervention.
There are many aspects to the treatment of diabetes. Oral medications are often the first line of treatment, but insulin injections may be required to keep blood sugars in check. These are prescribed by a primary care physician or endocrinologist whose care is essential to the management of diabetes. Yearly exams with a podiatrist are essential to help keep feet in good condition and prevent as well as treat problems that may arise. There are treatments available for neuropathy including topical medications, oral medications, and medical grade food supplements like Metanx (which we will cover in more detail in a future blog post). Diabetic shoes can be ordered and are typically covered by insurance.
If you have diabetes you should establish care with a podiatrist for at least yearly checkups even if you don't currently have any problems. Keep your feet healthy and happy so that you can keep doing what you love to do! If you need to have your diabetic feet checked call our office and schedule an appointment today! Any of our staff will be happy to help you.