Foot Care News For People With Diabetes
Foot care for people with diabetes should be a regular part of each day.
Patients with diabetes can develop nerve damage affecting their feet. Imagine stepping on a sharp piece of glass and not knowing the glass has cut the skin. Not knowing, that is, until you see blood on the sock or shoe. This is called a sensory neuropathy. Sometimes this nerve damage causes a constant burning sensation in the feet. The constant burning sensation can sometimes be treated with topical cream or oral medications. The ‘sensory neuropathy’, or, complete loss of feeling, however, is not reversible.
Like many complications of diabetes, nerve problems usually develop after many years of poorly controlled blood glucose levels. The entire foot does not become ‘numb’ at once. Rather it starts slowly at the toes and the loss of sensation continues toward the rest of the foot. The person with neuropathy can not determine if he or she had stepped on a sharp object, and the nerve damage also causes the skin around the foot to become very dry and scaly.
In more advanced cases, even the shape of the foot changes. The combination of a lack of sensation and an abnormally shaped foot are two risk factors for developing skin ulcers. These ulcers can lead to serious infections and amputations if not treated early.
Two easy techniques are used to determine if a patient has a loss of feeling in the feet that is significant. One test uses a tuning fork. If the patient can feel the vibrating tuning fork when held against the foot, a lack of sensation, or neuropathy, is unlikely. Another test uses a special piece of nylon filament calibrated to bend at a specific pressure. If the patient can feel the nylon filament against different parts of his or her foot, the patient does not have a complete sensory neuropathy.
Since a neuropathy does not develop all at once, the American Diabetes Association recommends that people with diabetes have their feet checked at least once each year by a health professional. Your doctor should check the pulses in your feet. If the doctor suspects poor circulation, he or she may recommend further testing. The doctor will also check for nerve damage.
The last part of the foot exam will be to determine if any foot deformities exist. Any area of redness or swelling in the foot will also be noted.
The doctor may recommend special shoes for some patients. In most cases, patients with diabetes who require special shoes can find certain off-the-shelf shoes. If the boney areas in the foot continue to turn repeatedly red and irritated even after wearing the correct shoe, some foot deformities in patients with diabetes will respond well to surgery and help prevent problems in the future.
By maintaining good control of blood glucose and good foot health, patients can usually avoid foot related complication of diabetes. People with diabetes should have their feet checked by a foot health specialist at least once a year. They should also visually examine their own feet for any change in appearance or sensation daily. And most importantly, any foot injury or change in appearance should be reported to your doctor promptly.
ARE YOUR FEET HIGH RISK?
If you have diabetes and you answer yes to any of the following questions, your feet may require special attention from a podiatrist:
IF YOU HAVE A LACK OF FEELING IN YOUR FEET
Written by Howard E. Friedman D.P.M., a member of the Foot Care Council of the American Diabetes Association and the American Podiatric Medical Association. Practicing in Suffern, NY.