Foot reminders – Get them examined!
One of the sessions I attended at the American Diabetes Association (ADA) meeting this year dealt with diabetic neuropathy-damage to the nerves by diabetes. The session specifically focused on foot care and diagnosis. I have to say, there were some very interesting and outright cool research studies coming down the pipeline, having to do with new ways to test for nerve damage and recovery, etc.{{more}}
BUT they focused on some of the very simple examinations and tools you find in most doctors offices, so I would like to stress them to you again. Yes, some of the high tech tools give much prettier pictures to look at, but when it comes down to it the simple tools can do a pretty impressive job as well.
One main focus was on the Monofilament. Many of you with diabetes should have seen these in your doctorsâ offices, or perhaps you saw it during our visit in the medical mission in April of this year. The monofilament is a very thin piece of usually plastic, made to be a certain tensile strength in terms of bending. By pressing it firmly on the bottom of your feet/toes, we can find out if you have loss of sensation from nerve damage due to diabetes. It seems quite simple, almost deceptively so. Why canât we use any old piece of wire then? Or pieces of paper? Or just a finger? Well we can use all kinds of things to test for sensation, that is true.
The beauty of the monofilament is that it is standardized. Therefore, just like comparing from one ruler to another where you can say 12 inches is the same all around, if you use the monofilament properly you can make statements about findings between monofilaments. You cannot do that if you measure one time with a wire from your garage and another time with a piece of paper, right?
Proper use of monofilaments has been shown to correctly not only diagnose diabetic nerve damage but also predict development of future diabetes when early nerve damage is found. Amazing! The trick of course is that you need to have the monofilament test done in the first place, and then have it done in the future for comparisons in order to track changes. Remember, some people never develop painful diabetic neuropathy. Many people have the numbness only, so they never fully appreciate how much damage they truly may have. If you have pain, tingling or burning, chances are that you know full well that you have nerve damage. You can however have those symptoms with or without numbness, so even then the monofilament test can help show if you have lost ability to feel.
My plea goes out again to you: please be sure that your doctor looks at your feet, and does an exam for loss of sensation. He/she should also most definitely ASK you about symptoms of neuropathy on your feet, including numbness, tingling, burning, pain, feeling like ants on your skin, and restless legs at night (canât keep still). Undiagnosed diabetic neuropathy can lead to serious complications like infections and later amputations, so please be proactive about this-get your feet examined every time!!!
Until next time, stay safe and healthy Vincies!
Anita Ramsetty, MD endodocs@endocrinehelp.com
Medical Director Endocrine Care Group
www.endocrinehelp.com
Tel: 843-798-4227
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