It is estimated that 34.2 million people (10.5% of the population) in the United States have diabetes according to the National Diabetes Statistics Report of 2020 generated by the CDC. What is astounding is that 88 million people aged 18 years or older have prediabetes (34.5% of the adult US population) and are at a high risk for developing diabetes. Unfortunately, these numbers continue to rise annually.
Prior to formally being diagnosed with the disease, approximately 7.3 million people are diabetic for at least 1 year, walking around undiagnosed. Many don't know that they have diabetes until they are seen in the emergency room, or hospital setting for an unrelated problem and are discovered to be diabetic.
Diabetes is a disorder that affects multiple systems and organs of the body including: the heart, kidneys, eyes, and the lower extremities, to name a few. High blood pressure, high cholesterol, inactive lifestyle, smoking, heredity, overweight and obesity are among some of the risk factors for developing diabetes. If you have any of the known risk factors, it is important to discuss screening for diabetes with your primary care doctor.
If you have diagnosed diabetes you are probably all too familiar with glucometers, daily finger sticks, and watching your diet. What many diabetics are not too familiar with; however, is the importance of diabetic foot care.
Diabetic Foot Care
If you have diabetes, it is imperative that you establish care with a podiatrist so that he/she may partner with you to keep your feet healthy for years to come. A diabetic foot exam should be performed at least once every 6 months for preventive measures. To practice good foot hygiene, your podiatrist may suggest you do the following:
Partner with your endocrinologist for better management of your diabetes
Check your feet daily
Refrain from barefoot walking
Hydrate the skin (however, refrain from applying creams in between the toes)
Do not ignore corns and calluses - as they are a risk factor for diabetic foot ulcers
Wear diabetic shoes and socks
Depending on the advancement of the diabetes and accompanying complications, your podiatrist may want to see you routinely for palliative care and preventive measures.
Diabetic Peripheral Neuropathy
With chronic or poorly controlled diabetes, patients are at a high risk for developing diabetic peripheral neuropathy which usually begins with numbness, tinging, burning, and/or pins/needles sensation at the tips of the toes. With worsening changes of diabetes, the symptoms of diabetic peripheral neuropathy progress proximally to the remainder of the feet and up the lower extremities. Most patients are bothered by these symptoms at night when trying to sleep. If severe enough, these symptoms keep many up at night. Unfortunately, these symptoms are seldom reversible. The better the blood sugars are controlled, the better the symptoms of peripheral neuropathy. Talk to a podiatrist about diagnostic and therapeutic treatment options for managing the symptoms of diabetic peripheral neuropathy.
Nerves help us sense our surroundings and keep us protected from potentially harmful stimuli. The biggest risk with diabetic peripheral neuropathy is that one can't rely on the ability of the nerves to sense the environment as well as we would like to protect ourselves from injuries. With diabetic peripheral neuropathy, one is not able to distinctly tell the difference between hot and cold, sharp and dull, and vibrations. If the neuropathy symptoms are severe enough, patients may not have any sensation to the entire lower extremity.
In advanced stages of neuropathy, patients may also be at a high risk for loss of balance and falls as muscles and tendons become contracted and cause rigid deformities such as hammer toes. If your rigid deformities are causing pre-ulcerative lesions such as calluses, pain, and difficulty with shoe gear, your podiatrist may recommend prophylactic correction of the deformity to prevent complications such as wounds, infections, and amputations.
Many diabetics also suffer from poor eyesight due to glaucoma. When this is coupled this with diabetic peripheral neuropathy, the risk for developing diabetic foot ulcers, infections, and amputations is much greater. Podiatrists are not just physicians and surgeons of the lower extremity, but they are also specialists who focus on limb salvage. Retaining a functional lower limb for years to come is of utmost importance to a podiatrist when treating a diabetic patient. Seeing your podiatrist for routine diabetic foot exams can help prevent many complications of the lower extremities from diabetes.
Resources:
Centers for Disease Control and Prevention. National Diabetes Statistics Report, 2020. Atlanta, GA: Centers for Disease Control and Prevention, U.S. Dept of Health and Human Services; 2020.
Comments