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Foot Problems and Diabetes
Q: Why are foot problems so common in diabetics? A: Diabetes affects the feet and legs in a few important ways. The sensation in the lower extremity decreases, and many patients have numbness or abnormal sensations like burning or tingling. The circulation is also affected, and many diabetics have decreased blood supply to the feet and legs. Additionally, the immune system does not work as well, leading to infections. Diabetics often do not feel a small blister, ingrown toenail or minor cut on their feet or legs. Problems with the circulation and immune system allow these minor problems to become infected, and large parts of the feet or legs can suffer permanent damage.
Q: Do all diabetics eventually get amputations of their toes or feet? A: No. The risk of complications in the from diabetes increases with the length of time the patient has diabetes, and how well the blood sugar is controlled. Many diabetics avoid serious complications by tightly controlling their diet and seeing their medical doctor and foot specialist on a regular basis.
Q: How can I avoid problems with my feet at home? A: As in many other diseases, prevention is the key to maintaining the health of your legs and feet. The feet must be checked every day to identify cuts, blisters, ingrown toenails, breaks in the skin or areas reddened from pressure. The shoes and soles of the feet must be checked too – use a mirror or ask someone to help you check. Never attempt to trim your toenails or calluses at home – this is a common way that infections begin in diabetic patients. Your podiatrist is trained to remove painful nails and calluses. Make sure that your shoes are fitted properly and are broken in gradually – do not wear new shoes more than one hour on the day you buy them. Also, do not walk barefoot under any circumstances and check bathwater with your hands before you put your feet in - remember that feet lose sensation first.
Q: Does diabetes run in families? A: Yes. There is good evidence that adult onset diabetes (Type II) is hereditary. We are not sure how the disease is inherited, so diabetes in a parent does not guarantee that you will get it. However, a family history of diabetes increases your chances of developing the disease.
Q: I was recently diagnosed with diabetes. What should I do now? A: First, see your medical doctor. Controlling your sugar with a combination of diet and medication is the first step. Remember that diabetes affects your entire body, and many areas must be watched closely – your vision, kidneys, circulation, heart, and your feet are prime target areas. Once your sugar is controlled and you develop a good relationship with the doctors treating all the areas we have discussed, you will be well on your way to preventing future problems.
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