It’s been quite a while since we tackled the topic of Diabetes, and because understanding the disease and the complications it can induce throughout the body and especially your lower extremities are so important, I want to refresh your memory. Over the next few weeks, we will discuss in detail the complications seen in lower extremities and what you can do to help yourself avoid or manage these.
Diabetes is an autoimmune disease that affects the levels of glucose (sugar) in your blood. In patients with diabetes, they either don’t produce enough insulin to breakdown their daily calories, or they make no insulin at all. Whichever type of Diabetes you have, either type can lead to complications in the lower extremities.
The first complication we typically see in the diabetic population is the loss of sensation on the plantar aspects of their feet, also known as Diabetic Neuropathy. High glucose levels in the bloodstream tend to induce changes around the nerve coverings beginning first with the hands and feet. For our purposes, it’s best to explain this as sugar molecules that grab onto the nerves in the feet and decrease their function: known as glycosylation within the medical community. There are good news and bad news in relation to glycosylation. The good news: in the beginning stages glycosylation is reversible – yay! The bad news: glycosylation can lead to detrimental insults to the plantar aspects of your feet and eventually your legs, working its way towards the center of the body.
The first step in understanding Diabetic Neuropathy or glycosylation of the nerves begins with understanding the symptoms. Do you ever experience numbness or tingling in your feet? Think of it as the “pins and needles” you would feel if your foot fell asleep. Do you ever experience a “burning” type of pain similar to when you hit your “funny bone?” These are both early signs of nerve changes in the feet and if not detected early on, their ability to be reversed is lost.
These feelings are a sign that the glucose levels in your bloodstream are too high, and better diabetic blood sugar control is necessary on your part. Whether that means changing your diet, increasing your medications, etc, to lower your blood glucose level, you need to take action. Taking such measures will help to decrease the effects of glycosylation and some sensation may return. However, once the glycosylation is too far along, these simple measures will no longer be helpful! Thus early detection is important, but prevention is key! Managing your blood glucose levels from day #1 of being diagnosed with diabetes will prevent and slow the progression and development of sensation complications.
The effects that loss of sensation has on your feet are great! Once you have lost the ability to feel, you’ve also lost the ability to know that you’ve stepped on something and that you now have a wound or ulceration on the plantar aspect of your foot. When you don’t realize this, you don’t realize that treatment may be necessary, the area gets dirty, gets infected, and leads to, in the worst-case scenario, infected bone, and loss of toes.
If you’ve reached the point where Diabetic Neuropathy has affected you, there are still things that you can do to prevent ulceration and infection. It’s as simple as checking your feet daily. So, what should you look for? You should look for any changes since yesterday on the bottoms of your feet, around your ankles, and in between your toes. By checking daily, you’ll notice any small differences immediately, even if you can’t feel them, and get treatment at the get-go. In addition, there are medications available that your Podiatric Physician can prescribe to help control the symptoms (burning, numbness, tingling) but none of these medications will restore feeling.
Don’t wait until the early signs of Diabetic Neuropathy set-in; control your blood sugar levels today and help prevent this complication for tomorrow!