By maintaining good control of blood glucose and good foot health, people with diabetes can usually avoid foot-related complications. 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 daily for any change in appearance or sensation. And most importantly, any foot injury or change in appearance should be reported to your doctor promptly.
People with diabetes can develop nerve damage which may affect 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 may 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 cannot determine if he or she has 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.
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 should 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 people with diabetes. In most cases, people who require special shoes may 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, they may need further medical treatment.
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:
- Do you have a loss of feeling in your feet?
- Has the shape of your feet changed?
- Are the joints in your feet stiff and rigid?
- Do you have poor circulation in your legs and feet?
- Have you had skin ulcers or amputations on any portion of your feet before?
