Diabetes and Your Feet

by Rebecca Pruthi, DPM

Diabetes is a continuing problem that is increasing in numbers worldwide. According to the American Diabetes Association, approximately 26 million children and adults currently have diabetes. Diabetes may affect several systems in the body, and sometimes the first signs people notice appear in the legs and feet. So if you are at risk for diabetes, you may want to remember moderation is the key before grabbing that extra sugary treat.

How does diabetes affect the feet? What to look for:

Nerves: One of the ways in which diabetes may affect the lower extremity is by affecting the nerves of the legs and feet, either by causing pain and tingling, or loss of sensation to pain, heat or cold. This is referred to as neuropathy. When visiting your podiatrist or physician for an exam, he or she can do a simple test in the office using a monofilament wire to evaluate if there is loss of sensation. Many diabetics simply lose feeling in their feet and toes. This may cause an increased risk of injury and infection, which makes even small cuts and blisters potentially dangerous. Therefore a simple measure, like checking your shoes for small pebbles or foreign objects before wearing them, can be a lifesaver.

Other nerve changes from neuropathy can cause permanent changes to the bone structure or muscles of the feet. Improper fitting shoes may lead to further destruction. Your podiatrist can recommend special therapeutic shoes in such instances.

Circulation: Healthy circulation is of extreme importance in patients with diabetes. However, it is frequently reduced as a result of this disease. Smoking, high blood pressure and cholesterol can further decrease circulation to the feet and lower limb. Your doctor can perform an exam on your feet and legs to help determine whether or not you have healthy circulation. Look for signs that include loss of hair growth, non-healing wounds and coolness in the feet and legs. Without adequate circulation, tissues usually cannot heal, and in severe cases this may lead to tissue death or limb loss.

Skin changes: These include dryness and calluses, which are commonly seen in diabetics. Nerves that control moisture and oil of the skin may no longer function properly and callus build up may result from friction. Calluses should only be treated by your physician to avoid ulcers or open sores from developing. Also, you should avoid chemical agents that may burn skin and lead to infection. After bathing, feet should be dried and then layered with a thin film of moisturizer, avoiding between the toes.

The feet can be a tell-all in the condition of diabetes. Therefore, it is important to know what to look for. If you have or suspect you have diabetes, follow up with your podiatric and medical physician.