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Your feet don’t lie

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In preparation for our Patsy Douglas Diabetes Initiative Mission trip coming up later this month, I would like to review with an article about foot care. Read on:

Ready to take those shoes off? Many of you already know that diabetes has effects on the feet and you can often tell a lot about the course of someone’s diabetes just by examining his/her feet.{{more}} Changes to skin, nerve and muscle happen over many years of having diabetes, especially badly controlled diabetes.

In regard to blood flow, there is usually a drop in blood flow to the feet after years of diabetes, mainly because of changes in your blood vessels. Just like all other parts of the body, the cells making up the skin, nerves, etc in your feet need blood to bring nutrients and oxygen to stay healthy. When this starts to drop off, then these cells are no longer able to stay as healthy as they once were. One of the most common findings is really thin skin, especially right over your shins, which tends to bruise very easily and sometimes leaves dark marks on your skin. There are fancy names for this – Diabetic Dermopathy being the main one – but they basically mean poor skin health and changes because of diabetes.

Nerve problems in the feet become unfortunately common in folks with long-standing diabetes and those with sugars out of control. It can happen quickly if your sugars are high all the time, or slowly if they are a little bit high over many years. There are many types of nerve problems that can happen due to diabetes. The most common symptom I hear in clinic is having “funny feelings” on the bottom of the feet, and sometimes higher up on the legs. For some folks, it is a burning feeling; for others it feels like ants on your foot, and some patients say they can’t describe it, but it feels strange and keeps them up at night. Some folks don’t feel anything on their feet and walk around for days with a cut without noticing. Sound familiar? If any of these scenarios is you, then you likely have diabetic neuropathy-nerve damage from diabetes. Sometimes, if caught early and blood sugars are brought under control, you can reverse some of the damage, but often it unfortunately is permanent. There are some medications that can help though, so speak to your doctor about that.

When your doctor asks you to take off your shoes and you protest saying, “my feet look/smell terrible,” think of me asking you to please swallow your pride and get those shoes off.

Your doctor will check for:

—Strong pulses in your feet for good blood flow

—The skin on your feet and legs for signs of damage from diabetes

—VERY IMPORTANT-any cuts that you may have missed, especially if they are not healing.

—Any dark toes/infected toes-very serious, should be taken care of NOW.

—Feeling on your feet and legs-he/she may touch your feet with their fingers or a thin wire. Sometimes using a vibrating metal fork,

—Any bones out of place on your foot

—Any swelling that may be a sign of heart problems.

See how much you can find just by looking at the feet? So, next time, put some lotion on your feet and get ready for an exam. Your feet won’t lie; listen to what they have to say.

Anita Ramsetty, MD [email protected]

Medical Director Endocrine Care Group

Tel: 843-798-4227