Diabetes? See A Podiatrist

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I have written before about the dangers of diabetes. It is not a disease to be trifled with. Unfortunately, all too often I have patients who admit that they really don’t follow a diabetic diet. I hear things like, “Well, I really enjoy a bowl of ice cream every night,” and other similar comments. Not too long ago, I was talking to a patient about his worsening diabetic numbers. He admitted to a nightly habit of eating jelly beans, which are essentially pure sugar. If you have diabetes and ignore it or you don’t adhere to the diet, you might as well walk across a busy street blindfolded because, essentially, that is what you are doing. Uncontrolled diabetes has many serious side effects. Today I would like to talk about the vascular, or blood vessel-related side effects.

Diabetes adversely affects large and small blood vessels causing heart disease, kidney disease, eye diseases including blindness, and foot problems, to name a few. It causes blood vessels to narrow or clog completely. In the legs, it affects the blood vessels supplying blood to nerves, causing numbness, tingling, and often pain in the feet. This is called diabetic peripheral neuropathy. While there are medications to alleviate some of the pain and tingling, the numbness will remain. When someone has diabetic neuropathy, they cannot feel their feet and often are not aware of small cuts and ulcers that form. These small breaks in the skin often become large ulcers that may go deep into the bones of the feet, necessitating weeks of intravenous antibiotics and sometimes, amputation of part of the foot. For this reason, it is imperative for someone with diabetes to pay special attention to their feet. The American Diabetic Association recommends an annual visit to a podiatrist, at a minimum. I suggest a podiatric visit at least every three to four months. The podiatrist will evaluate the feet, remove callus and dead tissue, and if an ulcer has formed, treat it before it gets to the point of amputation.

Here is a list of suggestions to keep a diabetic person’s feet healthy: keep your feet clean, dry, and well moisturized, wear shoes that fit well, inspect your feet daily, never walk barefoot (even at home), see a podiatrist for calluses, minor injuries, or ingrown toenails, see the podiatrist at least annually, maintain good blood glucose control, and don’t smoke. Also, as diabetes can affect the eyes, see an ophthalmologist at least annually. If you have diabetes and have pain, tingling, or numbness in your feet, be sure to see your doctor. Your doctor will also want to measure your hemoglobin A1c at least two to three times a year. The A1c is the preferred method of checking diabetic control as it measures control over several months as is not simply a snapshot of the now and present, as a blood sugar measurement is.   For more information go to:

www.diabetes.org/living-with-diabetes/complications/foot-complications/?loc=lwd-slabnav

www.apma/org/Patients/FootHealth.cfm?itemNumber=981

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