What is Diabetes?

Diabetes is the inability to manufacture or properly use insulin, and it impairs the body's ability to convert sugars, starches and other foods into energy. The long-term effects of elevated blood sugar (hyperglycemia) can lead to serious damage to the eyes, heart, kidney, nerves and feet. According to the American Diabetes Association, diabetes affects the lives of nearly 29 million people in the United States and nearly eight million don't even know they have the disease yet. 

While there is no cure for diabetes, there is hope. With proper diet, exercise, medical care and careful management at home, a person with diabetes can avoid the most serious complications and enjoy a full and active life. Today's podiatrist plays a key role in helping patients manage diabetes successfully and avoid foot-related complications. 

Symptoms 

Diabetes warning signs include the following: 

• skin color changes, 
• swelling of the foot or ankle, 
• numbness in the feet or toes, 
• pain in the legs, 
• open sores on the feet that are slow to heal, 
• ingrown and fungal toenails, 
• bleeding corns and calluses, 
• dry cracks in the skin, especially around the heel. 

Visit a Podiatrist 

Because diabetes is a disease affecting many parts of the body, successful management requires a team approach. Podiatrists are an integral part of the treatment team and have documented success in preventing amputations*: 

• More than 65,000 lower limbs are amputated annually due to complications from diabetes. 
• After an amputation, the chance of another amputation within three to five years is as high as 50 percent. 
• Including a podiatrist in your diabetes care can reduce the risk of lower limb amputation up to 85 percent and lowers the risk of hospitalization by 24 percent.  

*Source: APMA

The keys to amputation prevention are early recognition and regular foot screenings performed by a podiatrist, the foot and ankle expert. 

Take Action 

If you have diabetes, follow these foot care tips: 

• Inspect feet daily. Check your feet and toes every day for cuts, bruises, sores, or changes to the toenails, such as thickening or discoloration. 
• Wear thick, soft socks. Avoid socks with seams, which could rub and cause blisters or other skin injuries. 
• Exercise. Walking can keep weight down and improve circulation. Be sure to wear appropriate athletic shoes when exercising. 
• Shoes that fit. Have new shoes properly measured and fitted. Foot size and shape may change over time. Shoes that fit properly are important to those with diabetes. 
• Don't go barefoot. Don't go without shoes, even in your own home. The risk of cuts and infection is too great for those with diabetes. 
• Avoid self-removal. Never try to remove calluses, corns, or warts by yourself. Over-the-counter products can burn the skin and cause irreparable damage to the foot for people with diabetes. 
• See a podiatrist. Regular checkups by a podiatrist—at least annually—are the best way to ensure that your feet remain healthy. 

YOU Can Outsmart Diabetes! 

Of the more than 29 million people in the U.S. with diabetes, about half, will develop neuropathy - a loss of feeling in the lower extremities. This nerve damage means an open sore or injury on the foot may go unnoticed until it becomes infected, which can eventually lead to the need for partial or full amputation of the foot or lower leg. In fact, diabetes is the leading cause of non-traumatic lower-limb amputation. 

However, while the risk of foot complications may be frightening, there are many ways in which YOU can help outsmart diabetes! 

Take a step in the right direction by having your feet checked regularly by a podiatrist. Podiatrists are the most qualified doctors to care for your feet, based on their education, training, and experience! When you add a podiatrist to your health-care team, he or she can provide you with important information so you're able to better manage the effects of diabetes on your feet. 

Whether you've recently been diagnosed or have been fighting the disease for years, the resources below will help you to monitor your feet and prevent complications. 

Patient Resources

An Overview 
What is diabetes? What is peripheral neuropathy? What is a diabetic foot ulcer?

• Your Diabetes Management Team 
  Successfully managing diabetes takes a team of medical professionals. Learn about the importance of each one.
  Downloadable Pdf Your Diabetes Management Team
  
  
• The Real Cost of Diabetes 
  This infographic sheds light on the costs associated with diabetes and diabetic foot complications.
  Downloadable Pdf The Real Cost Of Diabetes
  
  
• Footwear Matters 
  Dr. Comfort created this infographic to demonstrate the benefits of therapeutic footwear for diabetes patients.
  Downloadable Pdf Footwear Matters
  
  
• Foot Health Advice for Patients with Diabetes 
  Spenco Medical put together this flyer with tips for managing foot health at home.
  Downloadable Pdf Foot Health Advice For Patients With Diabetes
  
  
• Diabetes Footwear and Products 
  View our podiatrist-approved products for managing and treating diabetes.
  
  
• Outsmarting Diabetes 
  Take a look at this suite of videos that highlight diabetes awareness tips and information for patients.
  
  
• Join the Conversation 
  Follow us on Facebook and Twitter to hear more about topics related to diabetes and foot health year-round.
• For additional patient information visit our consumer websiteNYfoothealth.com
  • Follow NY Foot Health on Facebook and Twitter

Additional information is available from the American Diabetes Association.

What is Peripheral Neuropathy?

Peripheral neuropathy is damage of the peripheral nerves. Your peripheral nerves—the nerves in your toes and fingertips—are the ones on the periphery of your body. When the nerves are damaged, they don't function properly. People with peripheral neuropathy have decreased or abnormal sensation in their toes and fingers. Sometimes, they develop problems moving these parts of the body as well.

Causes 

In the United States, the most common cause of peripheral neuropathy is diabetes. According to the American Diabetes Association, 60 to 70 percent of people with diabetes will develop neuropathy within their lifetime.

Other causes of peripheral neuropathy include: 

• Certain medications, including some chemotherapy drugs. 
• Heredity. Some people have a family history of peripheral neuropathy. 
• Advanced age. Peripheral neuropathy is more common as people age. 
• Arthritis. Certain type of arthritis can cause peripheral neuropathy. 
• Alcoholism. According to the US National Library of Medicine,  up to half of all long-term heavy alcohol users develop peripheral neuropathy.
• Neurological disorders. Certain neurological disorders, including spina bifida and fibromyalgia, are associated with peripheral neuropathy. 
• Injury. Acute injury to the peripheral nerves may also cause peripheral neuropathy. 

Symptoms 

The most common symptoms of peripheral neuropathy include burning, numbness, tingling, or shooting or stabbing pain in the toes and/or fingertips. Any change in sensation in the fingers or toes may be a symptom of peripheral neuropathy. Be sure to report any abnormal sensations to your doctor. Those sensations may be the first sign of another problem, such as diabetes.

Home Care 

If you have peripheral neuropathy, it is important to inspect your feet regularly. Because decreased sensation may develop eventually, you might not notice an injury or infection. Someone who has diabetes and peripheral neuropathy with loss of protective sensation, for instance, could step on a tack without noticing it. Regularly inspect your feet so you can note any injuries or infections and seek appropriate medical attention as needed.

If you're unable to properly inspect your own feet, enlist a family member or friend to help you. It's absolutely essential that any injuries are caught and treated promptly. Otherwise, an infection can develop and progress.

People with peripheral neuropathy should wear properly fitted shoes and avoid walking barefoot to prevent injury. If you have diabetes, it's important to control your blood sugar as well, because out-of-control blood sugar leads to increased nerve damage. Take your insulin or medication as prescribed and follow the recommended diet.

When to Visit a Podiatrist 

Everyone with peripheral neuropathy of the feet should see a podiatrist. Podiatrists are doctors who are specially trained to preserve the health of the feet.

Diagnosis and Treatment 

A podiatrist, family physician, internist or physician who specializes in diabetes can diagnose peripheral neuropathy. The diagnosis is made on the basis of a physical exam, health history and your reporting of symptoms. The doctor may order a blood test to check your blood sugar level because high blood sugar levels and diabetes are an important cause of peripheral neuropathy.

There is no known cure for peripheral neuropathy. The goal of treatments is to slow the progression of the disease, to maintain foot health and to decrease pain (if present) and improve the quality of life. A podiatrist may prescribe oral medication to help with pain. He or she will also perform a thorough foot check to look for any injuries or infections and will teach you how to do the same. Your podiatrist will also show you how to take care of your feet at home. People who have peripheral neuropathy should have their feet examined by a podiatrist at least once per year. 

If you also have diabetes, the podiatrist will work closely with you and other health-care professionals. Controlling the patient's blood sugar levels with diet, exercise, and medication, (if needed), can slow the progression of peripheral neuropathy and maintain foot health. 

Prevention 

The best thing you can do to prevent peripheral neuropathy is to keep your blood sugar levels under control. Peripheral neuropathy is common in people with diabetes, but the degree of neuropathy generally corresponds to the degree of blood sugar control. Someone whose blood sugar is kept under tight control will usually have much better sensation in his or her fingers and toes than someone with poorly controlled diabetes.