Neuropathy, or nerve damage, is one of the chronic complications of type 1 and type 2 diabetes. There is no set time-frame for when nerve damage will appear. Sometimes nerve damage appears without any symptoms, but then you may start to notice some changes in one particular part of your body. It is not unusual for your feet to be affected first… this is known as peripheral neuropathy.
Everyone who has diabetes would be wise to have an examination of their feet every time they see their health care provider about anything related to their diabetes. Early treatment of feet or foot problems can literally save your feet, and a skilled practitioner will also be able to recognize signs of heart disease or peripheral artery disease (PAD) just by examining your feet.
Here are three conditions your doctor will be able to see:
- if you have peripheral neuropathy, even if you don’t have foot pain
- why a lesion is in a particular spot on your foot… whether it is due to tight shoes, a joint issue, peripheral arterial disease, diabetes, or some combination of any or all of these problems
- whether a sore on your foot indicates a problem in your diabetic control
Treatment of your feet will include:
- infection… your doctor will take a swab from a sore on your foot or feet to make sure the bacteria or fungi present, if any, are sensitive to the antibiotic he is looking to prescribe
- vascular function… many doctors check blood vessel function with a hand-held Doppler (non-invasive). Your pedal pulse will also be palpated to make sure it is present or to check if it has decreased from your last visit
- mechanical… your doctor will be able to see if you are putting too much stress on a certain area of your foot
- metabolic… if your feet show symptoms of uncontrolled blood sugar levels, your doctor will be able to tell you what those symptoms are
- social… your doctor will check with you that you are carrying out daily foot checks, and how. He will also want to be sure you aware of the symptoms of neuropathy in your feet and legs
You have certain foot care responsibilities also… these are to:
- wear properly fitting and comfortable shoes that cover your entire foot
- moisturize… your skin is the first and best defense for your feet. Dry skin is prone to cracking and infection… moisturizing daily will prevent this but it is best to miss moisturizing between your toes
- it is not a good idea to wear nylon or any type of synthetic socks… they hold in perspiration. Excess perspiration on your toes can lead to fungal and bacterial growth. It is also best to avoid socks that cause irritation or leave marks on your feet
- if you sit for long periods of time, move your toes periodically to keep your blood circulating. Crossing your ankles or legs will also restrict circulation
Don’t hesitate to see a doctor immediately if you have:
- hot, swollen feet
- ulcers on your feet and cannot feel a pulse
- ever had any part of your foot amputated and you find a new lesion
You only get one body and one set of feet to go with it… it might not be your favorite thing to do, but having your health care provider check your feet at each visit could prevent major problems.