10 Tips For Diabetic Peripheral Neuropathy

Just because you have diabetic peripheral neuropathy does not mean that you are going to lose your feet. It just means that you have to be more vigilant and care when it comes to the care of your feet and ankle.
Here are some tips you can follow to avoid infection, injury, and amputation:

1. Check your feet every day. If you can't check your feet yourself, have a spouse, child, or invest in a mirror. If you have a cut, abrasion, puncture wound, or piece of debris in your foot, you will not feel it.
2. See a podiatrist. You should be seen at least once a year by a podiatrist and whenever you feel something is wrong, make an appointment. 
3. Watch your step. Just because you don't feel any pain in your feet doesn't mean there isn't something going on. You can't trust your feet anymore to give you signs. Be careful where you are walking.
4. Clear a path. Before you go to bed, make sure there is nothing on the floor, just in case you have to get up in the night. You could potentially step on something or stub a toe, both of which you wouldn't feel.
5. Wear closed toe shoes. An exposed toe or foot has the potential for infection, harm, or injury, so wear closed toe shoes to prevent it from happening. 
6. Give up bare feet. If you can't feel anything in your feet, there is no way you will be able to tell if you cut, scraped, or have a puncture wound. We all love the feeling of barefeet, but for those with diabetic neuropathy, it is something to completely avoid. 
7. Trim toenails carefully. Infection can spread quickly when you nick your skin cutting your toenails. Ingrown toenails also puncture the skin and leave you vulnerable to infection. 
8. Wear shoes that fit. Shoes that are either too big or too small can cause calluses or blisters, which can easily turn into a sore if you're not careful and attentive. Your shoes should offer support and stability.
9. Take time to dry those feet! It's easier said than done when it comes to drying your feet, especially between your toes. Who thinks to dry their feet normally? But fungus loves wet, warm, moist environments. Yum. 
10. Exercise. Exercise is an excellent way to increase the circulation to your feet and maintain an active lifestyle. 

Reference: Diabetes Monitor
If you are a diabetic and do not currently see a podiatrist, call our Glastonbury or Middletown office to make an appointment.
Ayman M. Latif, DPM
Connecticut Foot Care Centers
Diabetic Foot Doctor in CT
Podiatrist in Glastonbury and Middletown, CT
Visit our website, like our page on Facebook, and follow my tweets on Twitter.

Why Do My Feet Tingle? Diabetic Peripheral Neuropathy

Diabetic neuropathy is nerve damage caused by diabetes. When it affects the arms, hands, legs, and feet it is known as diabetic peripheral neuropathy. Diabetic peripheral neuropathy is different from peripheral arterial disease (poor circulation), which affects the blood vessels rather than the nerves.
Three groups of nerves can be affected by diabetic neuropathy:

• Sensory nerves, which enable people to feel pain, temperature, and other sensations
• Motor nerves, which control the muscles and give them their strength and tone
• Autonomic nerves, which allow the body to perform certain involuntary functions, such as sweating.

Diabetic peripheral neuropathy doesn't emerge overnight. Instead, it usually  develops slowly and worsens over time. Some patients have this condition long before they are diagnosed with diabetes. Having diabetes for several years may increase the likelihood of having diabetic neuropathy.
The loss of sensation and other problems associated with nerve damage make a patient prone to developing skin ulcers (open sores) that can become infected and may not heal. This serious complication of diabetes can lead to loss of a foot, a leg, or even life.
The nerve damage that characterizes diabetic peripheral neuropathy is more common in patients with poorly managed diabetes. However, even diabetic patients who have excellent blood sugar (glucose) control can develop diabetic peripheral neuropathy. There are several theories as to why this occurs, including the possibilities that high blood glucose or constricted blood vessels produce damage to the nerves.
As diabetic peripheral neuropathy progresses, various nerves are affected. These damaged nerves can cause problems that encourage development of ulcers. For example:

• Deformities (such as bunions or hammertoes) resulting from motor neuropathy may cause shoes to rub against toes, creating a sore. The numbness caused by sensory neuropathy can make the patient unaware that this is happening. 
• Because of numbness, a patient may not realize that he or she has stepped on a small object and cut the skin.
• Cracked skin caused by autonomic neuropathy, combined with sensory neuropathy's numbness and problems associated with motor neuropathy can lead to developing a sore. 

Depending on the type(s) of nerves involved, one or more symptoms may be present in diabetic peripheral neuropathy.
For sensory neuropathy:

• Numbness or tingling in the foot
• Pain or discomfort in the feet or legs, including prickly, sharp pain, or burning feet

For motor neuropathy:

• Muscle weakness and loss of muscle tone in the feet and lower legs
• Loss of balance
• Changes in foot shape that can lead to areas of increased pressure

For autonomic neuropathy:

• Dry feet
• Cracked skin

To diagnose diabetic peripheral neuropathy, the foot and ankle surgeon will obtain the patient's history of symptoms and will perform simple in-office tests on the feet and legs. This evaluation may include assessment of the patient's reflexes, ability to feel light touch, and ability to feel vibration. In some cases, additional neurologic tests may be ordered.
First and foremost, treatment of diabetic peripheral neuropathy centers on control of the patient's blood sugar level. In addition, various options are used to treat the painful symptoms.
Medications are available to help relieve specific symptoms, such as tingling or burning. Sometimes a combination of different medications is used.
In some cases, the patient may also undergo physical therapy to help reduce balance problems or other symptoms.
The patient plays a vital role in minimizing the risk of developing diabetic peripheral neuropathy and in preventing its possible consequences. Some important preventive measures include:

• Keep blood sugar levels under control. 
• Wear well-fitting shoes to avoid getting sores.
• Inspect your feet everyday. If you notice any cuts, redness, blisters, or swelling, see your foot and ankle surgeon right away. This can prevent problems from becoming worse. 
• Visit your foot and ankle surgeon on a regular basis for an examination to help prevent the foot complications of diabetes.
• Have periodic visits with your primary care physician or endocrinologist. The foot and ankle surgeon works together with these and other providers to prevent and treat complications from diabetes. 

Richard E. Ehle, DPM
Diabetic Foot Doctor in CT
Podiatrist in Bristol, CT
Visit our website, friend and like our page on Facebook, and follow our tweets on Twitter. 

Related articles

• Partying To Excess: Alcoholic Neuropathy

  ---