Diabetes, one of the most prevalent, uncontrolled and life threatening diseases, affects millions of Americans daily. It is important to know that diabetes, while it affects the entire body in different ways, has many signs and symptoms that appear in the legs and feet first. Good control of diabetes is the key to avoiding many of these risk factors associated with the disease.
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One of the biggest and scariest risks of uncontrolled diabetes is amputation. There are many ways to control and overcome diabetes so that something as major as an amputation can be avoided.
Below are the three most important aspects of a diabetic foot examination. A thorough examination of these factors by your foot doctor can help prevent many minor and major foot problems.
Uncontrolled diabetes affects blood flow in the legs and feet. It can cause blockages of small and large vessels leading to many different problems including pain, swelling and wounds that do not heal properly.
A very quick and simple test, where your physician simply feels the pulses of your foot and ankle, can provide a lot of important information. This test can tell whether a major artery is pumping, if it’s weak or not pumping at all- just by a simple touch. Other simple tests, if necessary, are also preformed with ultrasound and other diagnostic tools to look deeper into blood flow of the legs and feet.
Peripheral neuropathy, or the abnormal function of nerves in the legs and feet, is also very common among diabetic patients. Due to the excess sugar in the body, the nerves start to act up. You can think of it like the sugar wrapping around the nerves, which does not allow the nerve to send proper signals down its path. Peripheral neuropathy can feel like pins and needles, tingling, hot, ice cold, burning, numbness, a combination of these or all of the above.
Just like with blood flow tests, a quick, painless nerve test with a small plastic bristle and vibrating tuning fork can allow your physician to evaluate how well your nerves are working. It can also tell exactly which types of nerves are affected. There are many ways to treat nerve pain and peripheral neuropathy, but be aware that sometimes the feelings may never go away completely.
Condition of Skin and Nails
Uncontrolled diabetes can also cause skin and nail problems including dry, flaky, discolored or thick skin and nails, wounds that take a long time to heal and infections. Although some of these are not directly caused by diabetes, having the disease can make these problems much more complicated, especially if there is any blood flow problem and/or neuropathy involved.
For example, a simple wound on the bottom of the foot can become infected and lead to gangrene or even amputation because you may not feel any pain or discomfort from the wound for days. Therefore, a simple daily visual inspection of your skin and nails can prevent problems before they even develop.
Preventative Measures You Can Take at Home
- Avoid barefoot walking, especially outside. Always wear protective and supportive shoes or slippers, even at home. Don’t wear completely flat shoes or slippers, and avoid extremely high heels. A 1-1½ inch heel shoe works well for most.
- Look at your feet DAILY for any problems or changes. Check the bottom of your feet (use a mirror or ask a family member for help if necessary). Check between the toes for any discoloration or excessive wetness. Dry your feet and the areas between your toes very well, especially after showers. If excessive sweating occurs, use over-the-counter foot powder or change your socks once or twice throughout the day.
- Moisturize your feet daily. Focus on tops and bottoms of feet. It is fine to moisturize the tips of toes if these are problematic or dry areas, but remember to keep the area between the toes as dry as possible.
- Never use sharp instruments at home to remove ingrown toenails or shave calluses. These can become wounds and get infected very easily.
- Avoid aggressive pedicures. It is fine to get nails cut, filed and painted. However, there should never be excessive digging around the corners of the nails and cuticles. It is very important to know that cuticles are there for protection against bacteria. It is very common to see infected toenails after cutting of the cuticles. Avoid this as much as possible.
- Follow a strict exercise program (minimum of 30 minutes of walking daily). Also, follow a diabetic diet and see your primary care physician or endocrinologist regularly to stay up to date on your medications and lab work.
- See your podiatrist for a diabetic foot examination at least once a year, and seek medical help immediately if you are having any problems out of the ordinary.