Diabetes has reached epidemic status in the United States, and the numbers are, unfortunately, only getting worse.
- Around 30 million Americans are estimated to have diabetes. Approximately one quarter of these cases are undiagnosed.
- More than 100 million Americans either have diabetes or prediabetes—which is marked by elevated blood sugar levels not quite high enough for a diabetes diagnosis. Without treatment or lifestyle changes, people with prediabetes are at extremely high risk of developing diabetes.
- Approximately 1 in 4 seniors 65 or over have diabetes.
- By 2030, it’s estimated that more than 50 million Americans will have diabetes.
Diabetes can trigger wide-ranging and damaging effects throughout the body. It’s linked with heart attack and stroke, blindness, kidney failure, and much more.
That “much more” includes your feet. In fact, diabetic foot complications are among the most common and most life-altering diabetic complications.
But why is diabetes so dangerous for feet? Why should high blood sugar make a difference?
A couple of things are going on here.
“A Slow-Acting Poison”
Now, under ordinary circumstances, your body uses carbohydrates (sugars) as a source of energy—first breaking them down into glucose.
Your cells need a certain amount of glucose to function properly, which is why glucose is always present in the bloodstream to some degree. However, it’s important that glucose levels don’t get too high or too low.
Normally, when blood sugar is too high, your body releases insulin to counteract it. But if your sugar levels stay too high or spike too frequently, over time, the insulin “pumps” have to stay on too long to keep up. Your body gradually becomes “desensitized” to insulin, making you less able to regulate sugar levels. This is Type 2 diabetes.
(In Type 1 diabetes, your body never produces enough insulin to begin with.)
Chronically high sugars levels will slowly damage your body’s cells. Arteries harden and narrow, reducing circulation. Organs, nerves, and tissues don’t get the nourishment they need and start to deteriorate and die.
And for many people, the feet are ground zero—the first place you begin to notice the damage that’s taking place.
The sensitive, delicate nerves of the lower extremities are extremely sensitive to high blood sugar levels. Over time, diabetes will damage them more and more, producing varied symptoms in the feet and ankles.
At first, you might feel an intermittent phantom pain—perhaps a tingling, shocking, or burning sensation. This is the result of sensory nerves deteriorating. Over time, the pain may become worse and worse, and more constant—until suddenly declining.
Unfortunately, that’s not a good sign. It means that your sensory nerves are so damaged that their connection with the brain is basically severed. Your feet become completely numb.
Sensory nerves are also not the only type of nerves that can be damaged by peripheral neuropathy. Damage to motor nerves can lead to muscle weakness and lack of coordination—or even gradual paralysis. And autonomic nerves that help regulate systemic functions (digestion, blood pressure, body temperature, etc.) can also be compromised.
Poor Circulation to the Feet
Blood flow to the feet and toes is already generally a lot lower than the core areas of your body. That’s one reason why fungal toenails, for example, can take so long to treat with oral antifungals.
But diabetes makes the problem a whole lot worse.
For starters, poor circulation can contribute to the nerve damage that occurs. But it can also independently produce further symptoms—cold sensations, swelling, joint pain, and constant muscle cramping being just a few.
More crucially, though, poor circulation will greatly reduce the ability of your feet to close wounds, repair damaged tissue, and fight off infections.
In other words, even small cuts and burst blisters on the soles of your feet could take weeks to properly heal. And if they get infected, the damage can spread to lower layers of skin, or even bone.
A Devastating One-Two Punch
Poor circulation and peripheral neuropathy are big enough problems on their own. But when combined, they put diabetes sufferers at extreme risk.
Say you accidentally cut the bottom of your foot. If you have healthy nerves, you’d probably feel it right away, then immediately clean, disinfect, and bandage the wound.
But if you have peripheral neuropathy, you might not feel the cut at all. You might even walk on the injured foot all day without knowing any better—until you see your bloody sock that evening when you take your shoes off!
Diabetes can take away both your foot injury warning system and your ability to fight infection and close wounds after they occur. That means if you aren’t checking your feet carefully every day, you might not even notice a severe problem until after a significant amount of damage has occurred.
If you don’t address the injuries early and aggressively, they could become sores that just don’t heal—and ultimately get infected. And if the infection deepens and cannot be counteracted, you may end up requiring an amputation.
In fact, more than 70,000 lower limb amputations are performed on people with diabetes every year in the United States alone. Diabetes is by far the No. 1 cause of non-traumatic lower limb amputations—and the sad truth is almost all of them are preventable!
So What Can You Do?
As we said, most of the worst complications of diabetes can be prevented with proactive care. It isn’t difficult to do this, but it does require discipline and consistency!
- Examine your feet carefully at least once per day. Do this in a well-lit room, using a hand-held mirror if necessary. Check the entire foot (including the nails and between the toes!) for signs of injury or damage. If you spot an ulcer or other problem spot that isn’t getting better, give us a call.
- Wash and dry your feet thoroughly every day to minimize your risk of skin infections.
- Always wear proper, comfortable, well-fitting shoes when out and about. If neuropathy is severe, you should wear them indoors, too. We can also provide specially made diabetic shoes that protect your feet and can accommodate custom orthotics.
- Do your best to manage your blood sugar and diabetes as best you can. This includes diet and exercise, monitoring your glucose, and keeping regular appointments with your doctor.
- Keep regular appointments with your foot care doctor as well—that’s us! We offer a lot of tools to help you. That includes circulatory and nerve health screenings, diabetic shoes, custom orthotics, maintenance foot care, and more.
If you’re suffering from neuropathy in particular, you should be pleased to know that Head to Toe Healthcare is also the home of the Tucson Neuropathy Institute. Our own Dr. Shih specializes in advanced treatments to help neuropathy sufferers reverse their symptoms and restore nerve function to the greatest extent possible.
Our comprehensive, multi-approach treatment may include guided cortisone injections, radiofrequency nerve ablation, laser therapy, or even decompression surgery if necessary.
Even if you’ve been suffering for years, and even if another doctor has told you nothing can be done, we may still be able to help!
Don’t Wait to Ask for Help
No matter how far along you are on the path of diabetic foot complications, we can help you. But in severe cases, the existing damage is not always completely reversible. And the longer you wait, the greater your risk of an injury, wound, or infection that leads to a catastrophic change in your quality of life.
So don’t wait until it’s too late! The earlier you see us, the better we can help you.
To schedule an appointment with Dr. Shih, please call (520) 545-5717 today.