Don’t miss early signs of diabetic foot

Doctor examining a person's foot

If you have diabetes and your feet go numb at times, that’s not unusual, but it can seriously affect your quality of life.

About half of people with diabetes lose feeling in their feet, a condition called peripheral neuropathy. Besides potentially being alarming, numbness can be painful and lead to falls when you lose your balance.

Having diabetes or high blood sugar levels for a while puts you at greatest risk for this condition, a result of damage to nerves in the feet.

What’s actually occurring is quite complicated and isn’t entirely known. But elevated blood sugar can damage nerves throughout the body. High blood sugar interferes with the nerves’ ability to send signals. It’s also believed that diabetes damages the very small blood vessels that supply blood to the nerves and can contribute to peripheral neuropathy.

Diabetic foot’s early warning signs can be vague and go unnoticed

Typically, you’ll experience slight numbness or tingling in your toes. This can progress, and eventually, you may not be able to feel pain or temperature differences. At night, symptoms often get worse.

How to care for your feet if you have diabetes

If you have diabetes, you should inspect your feet daily, keep your feet clean and dry, use a moisturizer to the tops and bottoms of your feet (but not between the toes) and wear well-fitting dry socks and well-fitting shoes or slippers at all times. You should trim your toenails carefully and straight across. All of these recommendations would also benefit anyone even if you don’t have diabetes.

Neuropathy can spread to the legs and other body parts

The most common type of neuropathy, or nerve damage, for people with diabetes is peripheral symmetrical neuropathy. That can cause numbness, tingling or burning pain to your feet, which can spread to your legs and can also affect your hands.

Focal neuropathy is less common and can affect one side or part of your foot, leg, thigh, hand or sometimes another part of your body. Another type of neuropathy, called autonomic neuropathy, can affect the heart, bladder, stomach, intestines, eyes and sex organs.

‘Diabetic foot’ has no cure

The goals of treatment are to reduce your pain, slow the progression and manage — and hopefully prevent — complications. Diabetic nerve pain can be treated with certain topical and oral medications.

Maintaining blood sugar in your target range is very important. If you consistently manage your blood sugar, that can even improve some neuropathy symptoms. As neuropathy progresses, complications such as open sores, usually called diabetic foot ulcers, can occur because of the lack of sensation in your feet.

Closely manage your blood sugar to prevent or at least delay diabetic foot

Hemoglobin A1C and blood glucose goals are individualized, but the American Diabetes Association recommends a hemoglobin A1C of less than 7%, and more than 70% of the time, your blood sugar should be in the target range of 70-180 mg/dL. Good blood pressure control, avoiding tobacco, staying active and eating a well-balanced diet can also reduce your risk of developing diabetic neuropathy.

Think you might have diabetic foot? Here’s what to do:

It’s not an emergency if you start to notice slight numbness or tingling in your feet. However, it’s certainly something you should bring up with the health care provider managing your diabetes (likely a primary care physician, nurse practitioner or an endocrinologist). That provider will examine your feet or refer you to a podiatrist for a foot exam and evaluation.

You might also be referred to a neurologist. The most common form of diabetic peripheral neuropathy, once advanced enough to affect sensation, can usually be diagnosed with a physical exam during an appointment. Sometimes additional tests can be done. Different types of diabetic neuropathy might require other types of testing.

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