If you’re someone who has diabetes, there’s a high likelihood that you’ll be visiting a Podiatrist (foot doctor) in the future. Diabetes wrecks havoc on a large percent of people’s bodies leaving them with neuropathy (tingling in the arms and legs) and numbness in the toes and feet. Some loose all feeling in their feet which makes it difficult for those to notice when a small blister has turned into an ulcer.
Diabetic Foot Ulcer
Ulcers form where there is friction or rubbing to an area of the foot. For someone who doesn’t have a loss of sensation in their feet, they would be able to notice they are in pain and to keep an eye on the sore to ensure it doesn’t get infected and to clean it properly. Unfortunately, when you can’t feel your feet, the problem may start out small but can escalate to a nasty infection fairly quickly.
There have been many of my previous patients who have actually been hospitalized due to the infection (from the ulcer) getting into their blood stream which causes sepsis. Others develop cellulitis which is an infection of the skin and can cause your lower legs and feet to swell and get red from inflammation.
The best measure when it comes to taking care of your feet is preventative. Take a look at your feet routinely or have your spouse or someone else look if you’re unable to bend like a pretzel.
The doctor, whether that’s your General Practitioner (GP) or Endocrinologist (diabetes doctor), will take a look at your feet at least once every three to six months. You’ll be asked to kick your shoes off and get comfortable. If your doctor hasn’t done this, I would speak up and ask for it.
A monofilament or little piece of plastic is what th doctor uses to test your foot to see if you can feel sensations in different areas. If he’s touching your heel and you feel nothing, that may indicate the start of neuropathy which can be treated with medications.
The most important way to keep your diabetes from damaging your nerves and causing all of this in the first place is to keep your blood sugars under control. Your body is not designed to run on an A1c number of 10%, ideally a good level is below 7%. You must be compliant in taking your medications as directed and make some lifestyle changes if you plan on being around for a while..
Untreated Foot Ulcers
As I mentioned before, when ulcers go untreated it can land you in the hospital with sepsis or on a heavy dose of antibiotics to reduce the inflammation and infection. Another thing to keep in mind- if you haven’t read my previous article about high blood sugars, I reference a story about a man I knew who wasn’t aware he had diabetes at all.
He had NUMEROUS complications, but one of them was ulcers in his feet where they ended up taking several toes from him. I say this not to gross you out, but to be very real and honest with you.
When you have diabetes it affects every major organ and everything from your eyes down to your toes. It is not something that you can take lightly and it won’t just get better on its own or if you ignore it.
There are many of you that won’t have a foot ulcer situation, but that doesn’t mean you won’t have the pleasure of seeing a Podiatrist. They are very popular in the diabetic community because they’re responsible for also trimming the toenails.
If your toenails start to turn yellow and become thick, this could indicate you have a toe fungus. There is medication that is used to treat this, but first a nail sample must be sent to the lab and can take up to 4 weeks to get a proper diagnosis.
There are a few different types of nail polish or laquers used to treat this, but most of the time it doesn’t work- at least from what I’ve seen. Currently, there’s only one medication that is used to treat the fungal infection, called Onychomycosis, which is Lamisil (generic: Terbenafine).
That medication is pretty potent and if you have a fatty liver, increased liver enzymes, cirrhosis, or any other liver disease, the doctor may not recommend treatment at all. This is because the Lamisil medication can irritate/aggravate your liver and cause further damage. You may even be asked to get routine liver testing while on the medication or at least have a fairly recent blood test to check how well your liver is working prior to starting on the medication.
If you aren’t a candidate for treatment, the nails will get thick and unruly. The Podiatrist will be the only one willing to trim back the nails to make sure they don’t cause any other problems. The GP will not be able to do this in the office, unless you have a jack-of-all-trades kind of guy/gal.
If you happen to have a loved one at a nursing home who has diabetes and foot/nail problems, more than likely they have a podiatrist that will make rounds and take care of trimming toenails and such on site. You can ask the nurse in charge if that’s something you or a loved one is dealing with.
That’s probably enough today about feet. Let me know if you have any questions or concerns about the above information. I would be happy to hear from you! I’ll talk to you all tomorrow where I spill the beans on the Whole30 program I’ve been doing. You won’t want to miss it!
For those of you that are new here, be sure to join the community where I can get a chance to connect with you and answer any questions you may have. Talk to you soon!
Your Advocate for Health & Hope