Diabetic Foot Problems
Regular foot care for most diabetics is essential in maintaining good foot health and preventing major complication. Corns, calluses, and ingrown nails in a diabetic should always be addressed in a serious fashion. In addition, every diabetic should have a foot screening performed by a podiatrist. Routine foot care every 2-3 months is a covered service under most insurance plans and diabetic shoes are covered by Medicare and some other insurance plans as well.
Neuropathy and Diabetes
High blood sugar (hyperglycemia) often leads to damage of the nerves throughout the body. Even recently diagnosed diabetics often have nerve damage (neuropathy) that is most noticeable in the extremities (peripheral neuropathy).
Symptoms are variable depending on which type of nerve is affected first. Often patients will present with numbness, tingling, burning or shooting pain mostly noticed at rest or night time. These symptoms usually worsen and patients may have difficulty sleeping. Balance, stability and loss of muscle strength may occur. The patients also slowly develop foot deformities such ass loss of arch height, hammertoes, and bunions. Feet may become cold, dry, scaly, and red with nail thickening. In time as the disease progresses the feet may become insensate (loss of all feeling). At this time patients are most vulnerable to developing ulcers and infections.
A complication of diabetic neuropathy is a condition called Charcot’s foot in which the foot becomes warm and swollen with little or no pain. The bones become soft and develop fracturing and dislocations that can lead to severe deformity. Since there is little pain the patients continue to walk, deformities worsen and often ulcers develop. To compound the issue the condition is often misdiagnosed for a bone infection, and patients are mistreated with intravenous antibiotics that do not help the condition.