DIABETIC NEUROPATHY AND THE FOOT
By Douglas Livingston, DPM, FACFAS
Diabetes is a diagnosis that is being made all too often and with it comes the need for vigilant foot care. The foot and the eye are two organs that are adversely affected by diabetes and its increased sugar levels. The effects on the foot are due to the small blood vessels that feed our feet and their distance from the heart. Those along with the constant trauma to which we subject our feet make the human foot a prime target for tissue breakdown and the development of ulcers that are resistant to treatment and can lead to amputations. This is why it is imperative for diabetic patients to seek regular professional care and observation. If any redness about the feet develops immediate attention is indicated. Unfortunately, all too often, the diabetic patient has decreased sensation about their feet and do not know that the tissues are breaking down.
Diabetic neuropathies are a family of nerve disorders caused by diabetes. Diabetic neuropathy can manifest itself with symptoms such as pain, tingling or numbness. And while it can affect any organ system, we as podiatrists, see it affecting our patients’ feet especially those patients who have problems controlling their blood glucose and those who are overweight. The type of neuropathy that affects the feet is peripheral neuropathy and the pain, tingling or numbness is often worse at night. Peripheral neuropathy may also cause muscle weakness and loss of reflexes, especially at the ankle, leading to changes in the way a person walks. Foot deformities, such as hammertoes and the collapse of the midfoot, may occur. Blisters, irritations and sores may appear on numb areas of the foot because of pressure or injury and can go unnoticed. If foot injuries are not treated promptly, the infection may spread to the bone.
It is recommended that people with diabetes have a comprehensive foot exam each year to check for peripheral neuropathy. People diagnosed with peripheral neuropathy need more frequent foot exams. A comprehensive foot exam in our office assesses the skin, muscles, bones, circulation and sensation of the feet. The sensation of the foot is measured and recorded. People who have lost protective sensation are at risk for developing foot sores that may not heal properly. Temperature sensation and vibratory sense are also part of the comprehensive examination.
Foot care specialists now offers innovative treatments to help our patients who suffer from diabetic neuropathy. We have had wonderful results from a non-invasive, painless therapy which increases circulation and sensation to the feet. Our office treats the diabetic patient with the special care and attention they need and we have board certified podiatrists who have been especially trained in limb salvage.
Livingston Foot Care Specialists’ website: www.livingstonfootcare.com