Stand Up to Diabetes - Protecting Your Feet

People with diabetes are at increased risk for developing problems with lower extremities. In fact, more lower extremity amputations are the result of diabetes than any other cause. Diabetics are at risk of nerve damage that can lead to decreased feeling in the feet. They are also at risk of vascular damage that can result in poor lower extremity circulation. With poor circulation, any ulcers that develop on the feet will be slow to heal. But, many amputations can be avoided with early detection of foot problems.

The primary means of preventing or slowing foot problems for diabetics is to control blood glucose levels. Maintaining blood glucose levels near their normal values will help reduce nerve damage and vascular damage, which lead to problems of the feet. Hemoglobin A1C levels should be tested on a regular basis to ensure appropriate blood glucose levels.

Another way to help control foot problems for a person with diabetes is to have annual foot exams. A diabetic's doctor should carefully examine the person's skin and nails of the foot and test for sensitivity. The doctor should also look for evidence of blood on the socks and ensure that the person's shoes provide adequate protection and fit properly.

A sensory exam can also be performed on the foot of a person with diabetes. During a sensory exam, the doctor will use a device that has a nylon filament that will deliver a ten-gram force. The doctor will touch the diabetic's feet beginning with the toes and working up towards the ankles to see how well the person can feel the device. This is a great exam to test if the person has begun developing nerve damage to the feet.

Educating a person with diabetes is a very important part of helping that person take preventive measures to protect their feet from damage and eventual amputation. The doctor should teach and then question the diabetic on topics such as foot care and the importance of maintaining normal blood glucose levels. In some cases the doctor should allow the patient to demonstrate how they take care of their feet to ensure the patient is in fact educated on taking care of their feet. The doctor should also teach them about the importance of choosing and wearing shoes that will protect their feet and that fit in a manner that will not cause damage.

After a thorough examination, the doctor will categorize the diabetic based on the level of risk the doctor believes the patient is so that appropriate care can be given. Lower risk people will not have thorough feet exams as often as those with a higher risk.

Unfortunately, many people with diabetes will eventually need a partial or complete amputation of a lower extremity. Most are those that simply cannot take care of their own feet, whether it's due to being elderly, overweight, undereducated, or lack of attention from their doctor. It is entirely possible to prevent this from occurring as long as conditions are closely monitored and appropriate measures are taken.