Imagine you are stuck with a pebble in your shoes and you cannot remove it! Painful isn’t it? That is exactly what a person with a diabetic foot feels…constantly! If you have frequent feet sores, you wouldn’t want to miss reading this!
Foot problems are very common in people with diabetes. In some cases, a diabetic foot even leads to foot amputations. But, you can avoid having diabetes-related foot problems by taking care of your feet every day and by managing your blood sugar levels.
* See below for tips to protect yourself against diabetic foot infections
Fun Fact: With more than 8000 nerves, and many nerve endings near the skin, the human feet are the most ticklish parts of the body! And, a lack of sensation might be due to peripheral neuropathy.
How does diabetes cause foot pain?
Both type 1 and type 2 diabetes cause damage to blood vessels and peripheral nerves, which results in problems in the legs and feet. People with uncontrolled diabetes usually have diabetic foot ulcers, diabetic foot infections and diabetic neuropathy. Apart from these, here are two major reasons why a person with diabetes should be worried about pain in the leg.
• Peripheral Artery Disease (PAD).
• Peripheral Neuropathy.
Peripheral Artery Disease (PAD)
Arteries present in the legs, arms, hands, and feet are called peripheral arteries. These arteries supply oxygen-rich blood to the muscles and tissues. When these arteries are blocked and narrowed due to the presence of fat deposits, cholesterol and plaque, it leads to peripheral artery disease.
Smokers and people with uncontrolled diabetes are at a higher risk of developing peripheral artery disease. If untreated, this condition can lead to strokes and heart diseases.
Who is at risk of getting peripheral artery disease?
People who:
• Smoke.
• Are overweight.
• Have high blood pressure.
• Lead sedentary lifestyles.
• Have a history of heart disease.
It might be peripheral artery disease if there’s:
• Leg pain with cramps.
• Numbness and tingling in feet along with coldness.
• Infections or sores on feet.
• Hair loss on the legs.
If you experience any of these symptoms, consult a doctor immediately.
Peripheral Artery Disease and Diabetes
People with diabetes have insulin resistance due to which the cells of the body cannot accept insulin and glucose. This leads to hyperglycemia (high blood sugar), and dyslipidemia (excess bad cholesterol). Over a period of time, people develop high blood pressure along with a buildup of fatty deposits in the arteries causing peripheral artery disease.
If you are a diabetic, here are a few tips to avoid peripheral artery disease:
• Quit Smoking.
• Work on diabetes control. Work towards getting your HbA1c to 6.5%.
• Reduce cholesterol levels.
• Avoid sedentary lifestyle.
• Reduce weight.
Peripheral Neuropathy
Diabetes causes damage to both the blood vessels and the nerves. When there is damage to the nerves, it leads to diabetic neuropathy. When damage occurs to the peripheral nerves, it leads to peripheral neuropathy.
Symptoms of peripheral neuropathy
• Decreased sensation in the nerves of the feet and legs.
• Difficulty perceiving injuries due to lack of sensation.
• Pain, tingling, or burning in the affected areas.
Peripheral neuropathy also causes the muscles of the feet to work improperly, leading to misalignment of the foot that can put pressure on certain areas of the foot. A most common manifestation of peripheral neuropathy in people with diabetes is diabetic foot.
What causes diabetic foot infections?
Prolonged elevated levels of blood glucose and uncontrolled diabetes causes severe nerve damage. Added to this, people with diabetes have a compromised immune system. The result is a diabetic foot.
Also, a combination of factors like reduced oxygenated blood supply, poor immunity, nerve damage, and damage to the skin tissue makes a person with diabetes more susceptible to injuries.
And when injuries, calluses, or sores occur they take longer time to heal. Moreover, since the blood vessels are damaged, medications do not act effectively. So, people diabetic foot ulcers should never neglect as it can result in foot amputations.
Diabetic foot symptoms
• Irritation and redness of the feet.
• Pain and swelling.
• Drainage from the wound (seen as stains on the socks).
• Blackening of tissue around wound or ulcer.
*Tips to protect yourself against diabetic foot infections
• Do not wear ill-fitting shoes.
• Do not wear high heels.
• Change socks frequently.
• Trim your toenails with clean toenail clippers. Do not keep them too short.
• Wash and wipe your feet regularly.
• Get yourself shoe inserts to prevent corns or ulcers.
• Wear prescribed Diabetes footwear.
• Consult a podiatrist or a diabetes specialist in case you have an ulcer.
Fun Fact: Having a tough time finding the right footwear? This might be due to the fact that as we age, our feet flatten thereby increasing the length and breadth of the feet.
Foot care for Diabetes
The Holy Grail of Diabetes Management
• Self-monitoring of blood glucose levels.
• Joining a Diabetes self-management program.
• Maintaining diet.
• Getting adequate physical activity.
• Never missing out on a single dose of medication.
• Getting periodical examinations.
Foot Care Essentials
Choose a trusted physical therapist who understands neuropathy to help you work through physical therapy methods in order to prevent further nerve damage. Proper attention to physical activity by an expert can prevent any further issues from occurring. Keep in mind, that physical therapy can soothe diabetic nerve pain, but not completely cure it. Here are a few ways to prevent the diabetic nerve pain.
Exercise
Regular physical activity helps you lose weight, which slows the progression of pain by reducing inflammation throughout the body and not just your feet. If you already feel minor symptoms of neuropathy, don’t stop moving. Find low-intensity workouts such as cycling or swimming to get in your heart rate pumping with some activity throughout the day. Talk to your healthcare provider about pain-free exercises that will suit you and your schedule.
Periodical Checkups
It is recommended that all patients be screened for DPN starting at diagnosis of type 2 diabetes, and five years after the diagnosis of type 1 diabetes, and at least annually after that, using simple clinical tests such as a 10-gauge monofilament to test nerve sensation in the feet.
Treat Pain Aggressively
Always be honest with your doctor about how you are feeling. If you have any feeling of pain or a tingling, numb sensation that might lead to pain which is not well controlled, the prognosis for further pain is much higher.
Hygiene
Diabetic nerve damage does not only cause pain but can also affect your ability to feel pain, so it’s important to maintain your feet. It’s best to check your feet every day for cuts, sores, swelling, and other problems, even if you don’t feel any problems. They can get infected, and untreated infections may lead to serious complications.
Glycemic Control
Keeping your blood sugar under control to prevent nerve damage is the best way to avoid nerve pain. Take your doctor’s advice for diet, exercise, and treatments if you already experience diabetic nerve pain. However, many treatments can help lessen the discomfort and pain caused by diabetic nerve pain, and your doctor can assist you in selecting the one that works best for you.
