Diabetic Neuropathy and Basic Foot Care
by Ralph J. Napolitano, Jr., DPM, CWSP, FACFAS
World Diabetes Day is November 14th, and November is National Diabetes Month here in the States. This year’s focus is on prediabetes and preventing diabetes. According to the CDC, more than 1 in 3 U.S. adults have prediabetes—that’s 88 million people—but the majority of people don’t know they have it. Prediabetes is a serious health condition where your blood sugar levels are higher than normal but not yet high enough for the official diagnosis of diabetes. The good news is that by making small, healthy lifestyle changes, it is possible to prevent type 2 diabetes and even reverse your prediabetes. Preventing and controlling diabetes is a massive topic beyond our blog this month but know that eating the right foods and exercise will pay huge dividends. If you are diabetic or prediabetic, proper foot care is essential to prevent minor problems from escalating to serious ones.
The elephant in the room per se with the diabetic foot is peripheral neuropathy. In this condition, high blood sugars irritate and damage nerves in the feet (and hands in advanced cases). Early on, this results in tingling and pain, a definite wake-up call to get your sugars in check and to seek medical care. If high blood sugars persist long-term, permanent nerve damage may result.
Peripheral neuropathy is quite serious because permanently numb feet lack protective sensation. Without protective sensation, foot injuries go unnoticed. Minor conditions such as simple blisters can progress to large, open wounds that threaten toes, feet, and whole legs. Therefore, one of the simplest but crucial aspects of diabetic foot care is the daily self-inspection of one’s feet. Things to look out for are areas of irritation, blisters, calluses, open sores, and foot deformities such as bunions and hammertoes. If mobility is an issue and one can’t contort as necessary to see the bottom of the feet, and between toes, a simple hand-held mirror does the trick. Hover a foot over the top of the mirror and have a look.
Above and beyond self-exams are diabetic foot exams and medical foot care at the hands of a medical professional such as a podiatrist. Having professional medical grade “routine” foot care can make all the difference in preventing problems before they start. Routine Foot Care is something that I do quite routinely at OrthoNeuro. It is a covered service with nearly all insurances. This care consists of trimming the toenails appropriately, keeping calluses at bay, and thoroughly inspecting the foot.
In our culture, feet live in shoes most of the time. I like to discuss not only foot health with my patients but “shoe health.” Well-made, correct-fitting shoes are of utmost importance for diabetic patients with neuropathy. Wearing “healthy” shoes certainly will protect the wearer. Ill-fitting, poorly made shoes will have the opposite effect.
I’ve written about shoes and choosing the right fit in my other blogs.
Finally, it’s exceedingly important to heed Benjamin Franklin’s words, “An ounce of prevention is worth a pound of cure,” when problems first start in the diabetic foot that has neuropathy. He coined this timeless phrase in 1736 to remind the citizens of Philadelphia to remain vigilant about fire awareness and prevention. And heading off problems in the neuropathic, diabetic foot is crucial for preventing a “firestorm” of serious health problems.
Wishing you a happy and healthy holiday season wherever you are, and wherever your feet may take you.
Dr. Napolitano is a double board-certified podiatrist and wound care specialist physician. (CWSP). He specializes in medicine, surgery and wound care of the foot, ankle and lower leg. He was the first podiatrist in the state of Ohio to earn the board certification Certified Wound Specialist Physician (CWSP).
“I strive to educate my patients thoroughly about their problem and offer a comprehensive and holistic treatment plan both medical and surgical. I believe healthy feet are the foundation for healthy living and will do my very best at all times to keep you active and moving along life’s journey—whatever your interests and wherever your feet may take you.”