What is Diabetes?

The food (mainly carbohydrates) we eat provides glucose, which the body’s cells require for energy. Insulin, a hormone produced by the pancreas gland, helps glucose to enter the cells from the bloodstream. When blood glucose levels rise, such as after a meal, the pancreas releases insulin, which helps lower the level of glucose in the blood by allowing it to enter cells. Without insulin, glucose builds up in the blood. Diabetes occurs when blood glucose, or blood sugar, levels are too high (hyperglycemia). This disease can cause nerve damage, poor circulation, and a weakened immune system, making it hard for the body to deliver oxygen and nutrients to a wound or injury. Diabetes can slow the healing process and make it difficult for the body to fight infections.

What is Diabetic Neuropathy?

Over time, high blood sugar levels associated with diabetes can damage the nerves throughout the body, resulting in a serious complication known as diabetic neuropathy. Diabetic peripheral neuropathy is the most common type of neuropathy seen by podiatrists because it causes nerve damage in the feet and lower limbs.

Symptoms of Diabetic Neuropathy in the Feet

Knowing what issues to look for and how to care of your feet properly will help you avoid serious problems.

Some of the most commonly experienced symptoms include:

  • Burning, shooting, or sharp stabbing pain
  • Numbness, tingling, or pins and needles sensation (paresthesia)
  • Extreme sensitivity to touch
  • Muscle weakness
  • Severe foot problems, such as infections, ulcers and sores, and damage to bones and joints
  • Slow healing of cuts, bruises, wounds or sores
  • Abnormal sensation that feels like aching, painful burning, or prickling (dysesthesia)
  • Total loss of sensation

Risk Factors

If you have diabetes, you are at risk for diabetic neuropathy or nerve damage. However, there are additional factors that further increase your risk, such as uncontrolled or difficult-to-manage blood sugar levels and number of years living with diabetes. Additional risk factors include high blood pressure, high cholesterol levels, obesity, and smoking.

Treating Diabetic Neuropathy of the Feet

Diabetic neuropathy can range from mild to severe but tends to worsen if steps aren’t taken to treat it. Your podiatrist can help you manage diabetic neuropathy by monitoring the health of your feet, prescribing orthotics, taking care of any injuries or foot wounds, and much more. Although there is no cure for diabetic neuropathy, proper treatment can address symptoms and slow progression.

If you’re in the early stages of the condition, conservative measures may be recommended, such as:

  • Maintaining stable blood sugar levels
  • Nerve pain medications
  • Regular foot exams by your podiatrist
  • Physical therapy
  • Casting
  • Acupuncture
  • Massage

For advanced, more severe, or cases unresponsive to nonsurgical treatments, surgery may be recommended to correct any foot deformities or remove infected tissue. Your podiatrist will discuss the potential advantages and risks of any surgery with you.

Proper Foot Care and Preventing Complications

  • Manage diabetes effectively
  • See your podiatrist regularly to have your feet checked—a healthcare professional may find an issue you’ve missed
  • Check your own feet daily, including the bottoms, thoroughly inspecting for redness, cuts, warts, irritation, or changes in skin or toenails
  • Wear properly fitting footwear, don’t wear tight socks or shoes, and never go barefoot
  • Use a toenail clipper to trim toenails straight across—if nails are thick, curved into the skin, or this is difficult for you, your podiatrist can do it for you
  • If you have corns or calluses, discuss safe removal with your podiatrist
  • Encourage blood flow to the feet by putting feet up when sitting, wiggle toes and circle your feet periodically during the day
  • Exercise regularly, in ways that aren’t too hard on the feet
  • Maintain a healthy weight
  • Stop smoking
  • Wash feet daily using warm water and soap, dry thoroughly, and apply powder or cornstarch between toes to soak up infection-causing moisture—do not soak feet or use lotion between toes