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Diabetes

The Diabetic Foot

Diabetes is a condition that requires proper management to prevent serious problems with your feet. It is estimated that 3,000,000 Canadians are affected by this disease, and many more are unaware that they have symptoms of pre-diabetes. Poor management of blood sugar levels can lead to diminished circulation and peripheral neuropathy (loss of feeling to the feet). Over many years, this could result in increased healing time, ulceration, and the need for amputation.

Diabetic Peripheral Neuropathy – What Is It?
Diabetes can cause many effects within your body. The main one that affects the feet and lower legs is diabetic peripheral neuropathy (DPN). Because the nerves are damaged, there is often pain, burning, tingling, a feeling of “pins and needles,” and even complete numbness in some cases. It is estimated that over 50% of diabetics have some form of peripheral neuropathy, but many do not have any symptoms. Over time, your risk for DPN and worsening symptoms is more likely. Other risk factors include being overweight and over the age of 40. Poor glucose levels will also affect the onset and severity of DPN, which ultimately impacts your ability to be mobile.

Why Are My Feet Numb and Tingly?
While this may seem like a contradiction, numbness and tingling are common symptoms of Diabetic Peripheral Neuropathy (DPN). They are usually worse when your glucose level is high. Many diabetics have trouble sleeping as the tingling may keep them awake at night.

How Is DPN Treated?
Peripheral neuropathy is one of the most challenging conditions to treat, and sometimes patients feel the “cure” is worse than the disease. Research tells us that we need to prescribe drugs, drugs and more drugs. The common types used include:

  • Anti-depressants
  • Pain Medications
  • Anticonvulsants

Diabetes meterAt Palmer Foot Clinic we have chosen to offer a selection of non-drug options including:

1) Topical Preparations

  • Biofreeze Spray
  • Neuragen

2) Light Therapy

  • Magnetic Bio Stimulation

Why Is It Important to Maintain a Proper Glucose Level?

Maintaining a proper glucose level is critical. This will allow your body to function more efficiently and will decrease the chance of developing problems throughout your entire body from your head to your toes. Your eyes, cardio vascular system, kidneys and your feet will all benefit from proper glucose control.

How Often Should a Diabetic Have Their Feet Checked?
Diabetics should inspect their own feet daily. In addition to this, an annual Comprehensive Diabetic Foot Exam (CDFE) should be completed for all diabetics. This will help to determine your risk level and will guide the future management of care. A person whose diabetes is well controlled and who has no symptoms of nerve damage will be considered at mild risk.

The next risk level is moderate, where there are some early nerve and circulation concerns, thus increasing your risk of infection and complications. You should have a CDFE done every 4-6 months.

If you have considerable loss of feeling or no feeling to your feet, you are considered to be at a severe risk. You may have already experienced a foot or lower leg ulcer, and your circulation is usually poor. Your foot care should be performed by a Podiatrist every 4-6 weeks in order to minimize your chance of infection. To protect your feet, you should be wearing accommodative insoles inside your extra width and extra depth shoes.

What Is Checked During a Comprehensive Diabetic Foot Exam (CDFE)?
Below is a list of things that may be checked during your foot examination:

  • 3 pedal pulses
  • Capillary refill time
  • Absence of hair growth
  • Temperature
  • Light touch sensation (using a small monofilament)
  • Vibratory sensation (using a tuning fork)
  • Proprioception
  • Muscle strengths
  • Reflexes
  • Gait
  • Balance
  • Pressure points on the feet (using our iStep digital scanner)
  • Footwear and inserts or orthotics
  • Type of socks you wear

Daily foot exams are an essential part of foot care for a diabetic. If you have difficulty reaching or seeing to do your own foot care, contact the Palmer Foot Clinic today for an appointment. Podiatrist Iain Palmer and his expert staff will help ensure that your feet receive the specialized care that they need. Call our Winnipeg, MB office today for an appointment. Dial (204) 697-0649.

*Regular check-ups of your feet are recommended for all diabetics. See specialty products for more information.

For more information – please see the Canadian Diabetes Association