Diabetics have a lot to worry about. Blood sugar, glucose, diet and activity levels all impact how the disease affects the body.
Diabetes can affect all systems in the body. Glucose, a type of sugar in the blood, thickens it—think of a sticky syrup that clings to everything. This thickening of the blood can cause damage and blockages in small blood vessels throughout the body.
Foot health is a key indicator of a diabetic’s overall health.
Diabetics can experience several conditions related to their blood sugar such as peripheral arterial disease, neuropathy and other conditions that require attention from a podiatrist. A podiatrist is a doctor who specializes in the health and treatment of the lower extremities.
Dr. Alan Bass, a Manalapan-based podiatrist and owner of Central Jersey Foot and Ankle Care, delved into common diabetic foot conditions and offers advice on treatment and prevention during a webinar on diabetic foot health.
Peripheral Arterial Disease (PAD)
PAD most commonly occurs in the legs and feet. It is caused by the reduction of blood flow when arteries narrow or become blocked with fatty deposits. It is similar to coronary artery disease.
Symptoms include pain and tiredness because your muscles and nerves do not get enough oxygen caused by circulation problems. Other signals of circulation issues include numbness, tingling or coldness. Extremely dry skin and sores or infections that don’t heal are also signs something is wrong.
A PAD diagnosis brings an increased risk of other issues such as heart attack, stroke and amputation.
More than one-third of diabetics over the age of 50 have PAD, and many don’t know they have it.
Doctors conduct specific tests to determine if a diabetic has PAD.
Neuropathy
Neuropathy is when the nerves in the feet (or hands) do not receive enough blood.
It can have two extremes. One where the patient has no feeling in the feet or another where it is very painful. The sufferer can experience temperature swings in the feet where they get very hot or very cold.
Neuropathy is very dangerous because the patient may not feel if they get a cut, sore, blister or burn. This can lead to a wound that won’t heal or an infection.
Controlling blood sugar can help reverse some of the neuropathy and restore some feeling.
Controlling Your Blood Sugar
Controlling your blood sugar is key to maintaining good health for diabetics. Daily glucose levels under 120 help foot health and circulatory issues. A1C, or long-term levels that are measured by a doctor-administered blood test, measure glucose in the body over a 60 to 90 day period for a longer look back on how the body has been processing sugars.
The more controlled the blood sugar levels are, it reduces the thickening of the blood in the circulatory system. This helps improve blood flow, take the strain off the heart (it doesn’t have to work as hard to move the blood throughout the body, it’s a long way from the heart to the big toe) and reduce the narrowing of the arteries, particularly to the extremities.
Overall Foot Health for Diabetics
Diabetics or their caregivers should check their feet daily for any changes. Take note of any issues such as red areas, hot spots or injury.
Hydration is also essential. A water-based moisturizer should be applied to the feet daily, but not between the toes.
Keeping the toenails in good condition also promotes good foot health.
Another thing diabetics need to be aware of is the shoes they are choosing. Shoes should fit well—not pinching or rubbing anywhere, protect the feet, and be worn at all times. Diabetics or caregivers should examine the shoes every time they put them on to make sure nothing has gotten inside that could cause irritation and check that the outside has not been compromised by something that could cause injury. Proper footwear is especially important for those receiving home care in Monmouth, as caregivers can assist in ensuring that appropriate shoes are selected and maintained.
About the Speaker
Dr. Alan Bass, a board-certified podiatrist and a certified professional coder (CPC). He owns Central Jersey Foot & Ankle Care in Manalapan, N.J.
He is also a Fellow of the American Academy of Podiatric Practice Management (AAPPM), in addition to serving on the Board of Trustees.
He is also is the CEO of JARALL Medical Management Consulting, providing business and practice management services for private practices.
He is a frequent lecturer nationwide in the area of medical and business management.
Dr. Bass has been practicing in New Jersey for over 25 years and is past president of the New Jersey Podiatric Medical Society and currently serves as an adjunct professor in the biology department teaching medical terminology and health at Kean University in Union, NJ.
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