Proper foot care is an important part of living with diabetes.
That’s because foot problems are extremely common when you have diabetes. If you don’t watch your blood sugar levels, foot problems can lead to open sores, infections and even amputations.
[See: Got Diabetes? Why You Must Protect Your Feet.]
The most common foot problem if you have diabetes is peripheral neuropathy, a disorder of the nerves. Doctors believe the biggest culprit is poor blood sugar control over time. “I tell patients that it’s as if their nerves have been short-circuited and nerve signals can’t get down to the feet,” says Dr. R. Randal Aaranson, a podiatrist and foot and ankle surgeon at Orthopedic Associates in St. Louis.
Neuropathy can affect other parts of your body, including your legs, hands and arms, but it’s most common in the feet.
About 60 to 70 percent of people with diabetes have some sort of neuropathy, according to the National Institute of Diabetes and Digestive and Kidney Diseases. Your risk increases as you get older.
Symptoms of Peripheral Neuropathy
Neuropathy has several symptoms, but the most common doctors see is a lack of feeling in the feet. “It’s a persistent numbness, and you can’t get your sensation back,” says Dr. Amir Assili, a podiatrist at Shady Grove Podiatry in Gaithersburg, Maryland.
This can be dangerous for several reasons. Without feeling in your feet, you don’t know if you’ve stepped on something that’s injured you. “You could step into a hamburger grinding machine and not feel it,” says Dr. Ronald Tamler, an endocrinologist at Mount Sinai Clinical Diabetes Institute in New York. More realistically, you could step on a nail, thumbtack, glass or other sharp items and not know, he adds. Another example: A pebble could get in your shoe and cause an ulcer or foot sore. Or you could be wearing poor-fitting shoes and not know it, Tamler says, which could damage your feet over time. You’re also at a greater risk of falling.
If you injure your foot and don’t know it, an infection could develop. An untreated infection can reach other parts of your body or lead to such severe damage in the foot that it requires amputation. In fact, more than 60 percent of nontraumatic foot amputations in the U.S. occur in patients with diabetes, according to the National Institute of Diabetes and Digestive and Kidney Diseases.
Depending on the severity of an infection that develops and how poor wound healing is, you could even die from problems related to neuropathy, Tamler says.
Other symptoms of neuropathy if you still have feeling in your feet include pain, burning, tingling and sensitivity to touch. These symptoms will worsen at night and may keep you awake.
However, the lack of feeling in the feet is the symptom that concerns doctors the most.
[See: 10 Myths About Diabetes.]
Treatments for Diabetic Neuropathy
Diabetic neuropathy can be a frustrating condition. “Patients who live with it try everything under the sun for it,” Assili says.
Before treating diabetic neuropathy in the feet, your doctor will likely do lab work to make sure your problem doesn’t have another cause. For instance, thyroid conditions, vitamin deficiencies, heavy metal poisoning and even alcoholism could create the same symptoms.
Pain-relieving creams you can rub on your feet are usually the first treatments your doctor will try if you have peripheral neuropathy. This can include capsaicin cream — which contains a compound found in many hot peppers — as well lidocaine patches.
Some doctors prescribe supplements that provide vitamin B1, B12, B6 or folate. These vitamins are thought to help improve pain, numbness and tingling associated with nerve damage.
If creams or vitamins don’t provide enough relief, the next step is oral medications. This can include certain antidepressants like nortriptyline or duloxetine or medicines commonly used for nerve pain, such as gabapentin and pregabalin. The antidepressant medications have been found to help the symptoms of diabetic neuropathy, even if the people using them are not depressed.
Acupuncture, biofeedback or physical therapy are effective for some people.
Beware of doctors who promise instant-relief treatments for diabetic neuropathy at a high cost. “There’s a lot of misinformation out there,” Assili says. Find out of your treatment is approved by the U.S. Food and Drug Administration, and always check with your doctor before you try something.
Unfortunately, diabetic neuropathy tends to be a lifelong condition. “There’s no instant gratification treatment,” Assili says. Doctors try and get patients to a point where they can tolerate the symptoms.
[See: The 12 Best Diets to Prevent and Manage Diabetes.]
Preventing Diabetic Neuropathy
If you have diabetes, there’s no guarantee that you won’t develop diabetic neuropathy in your feet. However, good blood sugar control is one way to help reduce your chances of developing it or keep worsening symptoms to a minimum.
There are also a few things you can do to decrease the risk for problems caused by diabetic neuropathy:
Have your feet checked by a doctor regularly at least once or twice a year. This could be your primary care doctor, endocrinologist or a podiatrist. Assili will see some patients every three months if they’ve had recent problems, or once a week if they have an ulcer that requires treatment.
Wear durable shoes at all times — even at your house. “I can’t tell you how many people I’ve seen step on thumbtacks and nails at home,” Aaranson says. Wear shoes in outdoor settings where your friends may go barefoot, including the beach. Hot sand and seashells could cause an injury, and you wouldn’t know it.
Check the bottom of your feet daily. “Keep a mirror next to the entry of your shower, and look for injuries,” Tamler recommends.
Quit smoking. It can make neuropathy worse.
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Treating (and Preventing) Diabetic Neuropathy originally appeared on usnews.com
