Diabetic Neuropathy: How It Affects Your Feet
Foot problems are common in people with diabetes. Here’s what you need to know.
If you have diabetes, you’re probably aware that foot problems can be a common complication of the disease. While it’s scary to think about the most serious foot complications, such as amputation, it may ease your mind to know that by managing your blood sugar and taking good care of your feet, you can dramatically lower your risk of diabetes-related foot problems.
How Diabetes Affects Your Feet
“Foot problems are common in people with diabetes because it boils down [to] elevated blood sugar. Blood sugar elevations prevent nerves from transmitting signals in the manner in which they should,” says Minisha Sood, MD, an endocrinologist in New York City.
Over time, this causes nerve damage, also known as diabetic neuropathy. “If nerves don’t function well, people with diabetes can’t feel pain [and] they can’t feel when their feet are being damaged, says Dr. Sood. “If they can’t feel when their feet are being damaged, they can get a cut that might get infected, or an ulcer that might get infected, and they only know about it when it’s too late.”
Diabetes can also cause decreased blood flow to the feet. Not having enough blood flow to your legs or feet can make it hard for a sore or an infection to heal, which may lead further complications, including gangrene, or the death of body tissue due to lack of blood flow. People with diabetes also have an increased chance of developing foot sores, called diabetic ulcers. Gangrene and foot ulcers that do not get better with treatment can ultimately lead to amputation.
Signs of Diabetic Nerve Damage
Patients who have diabetic neuropathy may feel a pins-and-needles sensation, burning, or numbness in the legs or feet. “Some patients are severely numb and some patients just start to lose just a little bit of sensation in their feet,” says podiatrist William Spielfogel, DPM, chief of the division of podiatry at Lenox Hill Hospital.
“You could live a very long time with neuropathy, but the problem is, if you’re walking and you have a lack of sensation, you’re not feeling what’s going on at the bottom of your foot, and you can wind up with a serious condition which can leave to an amputation,” says Dr. Spielfogel.
How to Lower the Risk of Diabetes Foot Problems
If you have diabetes, managing your blood sugar levels is the most important thing you can do to prevent foot problems, says Dr. Sood. It’s also essential to pay attention to and care for your feet. “Address little cuts, scrapes, and cracked skin areas early, and don’t let them fester and collect bacteria, because that can turn into infection,” she says. To care for your feet properly, follow these foot care tips for people with diabetes and take care to avoid blisters and soothe cracked heels.
People with diabetes should see a podiatrist at least once a year, even if they don’t show signs of foot problems. “If you have complications, if you have peripheral neuropathy, or if you have peripheral vascular disease, you should be seeing a podiatrist on a more regular basis,” says Dr. Spielfogel. “It’s really just as a preventative measure because we want to avoid the complications of diabetes, such as ulceration of these non-healing wounds and amputations.”
Dr. Sood is a board-certified endocrinologist in private practice in New York City and an assistant professor at Hofstra School of Medicine.
William SpielfogelDr. Spielfogel is the chief of podiatry in the department of orthopaedic surgery at Lenox Hill Hospital in New York City.
1
00:00:00.000 --> 00:00:02.410
(upbeat music)
2
00:00:02.410 --> 00:00:04.720 line:15%
Foot problems are common in people with diabetes
3
00:00:04.720 --> 00:00:06.990 line:15%
because it boils down to elevated blood sugar.
4
00:00:06.990 --> 00:00:09.710
Blood sugar elevations prevent nerves
5
00:00:09.710 --> 00:00:11.170
from transmitting signals
6
00:00:11.170 --> 00:00:12.920
in the manner in which they should.
7
00:00:18.640 --> 00:00:21.700
Neuropathy, or diabetic neuropathy is nerve damage
8
00:00:21.700 --> 00:00:24.320
from poor blood flow to the nerves.
9
00:00:24.320 --> 00:00:25.640
If the nerves don't function well,
10
00:00:25.640 --> 00:00:28.280
people with diabetes can't feel pain.
11
00:00:28.280 --> 00:00:30.880
They can't feel when their feet are being damaged.
12
00:00:30.880 --> 00:00:33.130
And if they can't feel when their feet are being damaged,
13
00:00:33.130 --> 00:00:35.100
they can get a cut that might get infected
14
00:00:35.100 --> 00:00:37.590
or an ulcer that might get infected
15
00:00:37.590 --> 00:00:39.180 line:15%
and they only know about it when it's too late.
16
00:00:39.180 --> 00:00:40.750 line:15%
One of the sensations
17
00:00:40.750 --> 00:00:43.970 line:15%
of neuropathy is a pins-and-needles sensation.
18
00:00:43.970 --> 00:00:46.780
You could also feel a burning sensation in your feet
19
00:00:48.130 --> 00:00:49.970
or just complete numbness.
20
00:00:49.970 --> 00:00:51.970
Some patients are severely numb
21
00:00:51.970 --> 00:00:53.410
and some patients start
22
00:00:53.410 --> 00:00:56.660
to lose just a little bit of sensation in their feet.
23
00:00:56.660 --> 00:00:58.850
You could live a very long time with neuropathy
24
00:00:58.850 --> 00:01:00.330
but the problem is
25
00:01:00.330 --> 00:01:04.120
that if you are walking and you have a lack of sensation,
26
00:01:04.120 --> 00:01:06.390
you're not feeling what's going on
27
00:01:06.390 --> 00:01:07.680
on the bottom of your foot
28
00:01:07.680 --> 00:01:10.030
and you can wind up with a serious condition
29
00:01:11.600 --> 00:01:13.340
which can lead to an amputation.
30
00:01:13.340 --> 00:01:14.920
In order to prevent foot problems
31
00:01:14.920 --> 00:01:16.240
in patients with diabetes,
32
00:01:16.240 --> 00:01:18.060
glucose control, or blood sugar control,
33
00:01:18.060 --> 00:01:19.730
is the most important thing
34
00:01:19.730 --> 00:01:21.770
and then regular attention to your feet.
35
00:01:21.770 --> 00:01:23.930
Address little cuts and scrapes
36
00:01:23.930 --> 00:01:26.070
and cracked skin areas early
37
00:01:26.070 --> 00:01:27.860
and don't let them just kind of fester
38
00:01:27.860 --> 00:01:29.110
and collect bacteria
39
00:01:29.110 --> 00:01:31.020
because that could turn into an infection.
40
00:01:31.020 --> 00:01:33.440
If you don't have any complications,
41
00:01:33.440 --> 00:01:35.830
diabetic patients should see a podiatrist once a year.
42
00:01:35.830 --> 00:01:38.460
If you have any of these complications,
43
00:01:38.460 --> 00:01:40.320
if you have peripheral neuropathy,
44
00:01:40.320 --> 00:01:42.800
or if you have peripheral vascular disease,
45
00:01:42.800 --> 00:01:45.690
you should be seeing a podiatrist on a more regular basis.
46
00:01:45.690 --> 00:01:47.870
And it's really just as a preventive measure
47
00:01:47.870 --> 00:01:51.520
because we want to avoid the complications of diabetes
48
00:01:51.520 --> 00:01:53.220
such as ulceration
49
00:01:53.220 --> 00:01:57.013
and these non-healing wounds and amputations.
50
00:01:57.013 --> 00:01:59.596
(upbeat music)
Diabetes and Foot Problems. Bethesda, MD. National Institute of Diabetes and Digestive and Kidney Diseases. (Accessed on May 5, 2021 at https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-problems/foot-problems)
Evaluation of the diabetic foot. Waltham, MA. UpToDate, 2020. (Accessed on May 5, 2021 at https://www.uptodate.com/contents/evaluation-of-the-diabetic-foot)