People with diabetes can, over time, have damage to nerves throughout the body. This nerve damage is called “diabetic neuropathy.” It can cause numbness, tingling, pins and needles, burning, and sometimes pain and weakness in the hands, arms, feet and legs. It may also occur in other parts of the body, including the digestive tract, heart, and sex organs. Diabetic neuropathy is more common in people who have trouble keeping their blood sugar under control. While nerve problems can develop at any time, the longer a person has diabetes, the greater the risk.

What could happen to your feet when feeling is lost?

With diabetic neuropathy you “lose your alarm system” for injury. This alarm system protects you. When you feel pain, you limit your activity. With pain and feeling gone, you may not be aware of things like:

• Poorly fitting shoes
• Blisters
• Stepping on a tack or sharp object
• Ingrown toenails

Injury can put you at risk for serious foot problems such as:

• Foot ulcers
• Infection
• Death of healthy tissue (gangrene)
• Loss of your toes, foot or leg (amputation)

 Reduce the risk of diabetic neuropathy

The best way to reduce your risk for diabetic neuropathy, is to keep your blood glucose levels as close to the normal range as possible. Good blood glucose control may help prevent or delay problems. Things you can do to help:

• Monitor your blood glucose
• Eat proper meals
• Exercise
• Take your oral medicines or insulin as directed
• Practise proper foot care

 Foot Care Tips

Practising proper foot care is one of the most important things you can do for yourself. This simple act may prevent ulcers, amputations, and could also lengthen your life!

1. Check your feet every day.
2. Use a mirror to perform daily self-examinations, if you’re unable to see the bottom of your feet.
3. Clean your feet daily and moisturise, but not between the toes.
4. Ask your healthcare provider about getting special shoes and socks.
5. Be careful not to wear shoes that are smaller than your feet.
6. To ensure the correct fit, be measured for your shoes at the end of the day; it’s when your feet tend to be the most swollen.
7. Avoid shoes with seams.
8. Check for torn linings, or foreign objects, each time before putting on your shoes.
9. Wear slippers with thick soles, when you get up at night to go to the bathroom.

 The Right Shoes and Socks Matter

Choose shoes wisely. Skip the high heels, flip-flops, and going barefoot. Comfortable, supportive shoes that fit well, along with dry socks, will help protect your feet from damage.

Go for comfort. Have both feet measured, and buy shoes that fit your larger foot. Don’t buy shoes that you’ll have to break in. Wear shoes at all times, including at the pool or beach.

Choose foot-friendly socks – Look for socks without seams (these can rub and cause skin breaks); also ensure that they aren’t tight. Change your socks daily to eliminate risk of foot fungus.

Get a Comprehensive Foot Exam – It is important to visit your podiatrist at least annually, to have your feet checked.

Be sure to take off your shoes and socks when you get into the exam room at your podiatrist’s office. They would check for circulation problems, nerve damage, skin changes, and deformities (like hammer toes, bunions or other foot changes). They will ask you about symptoms, your home care routine, and your shoes too.

You may need more frequent foot checks. The American Diabetes Association recommends foot exams every 3-6 months, if you’re losing protective sensation in your feet; every 2-3 months if you have loss of protective sensation, plus peripheral artery disease; and every 1-2 months if you have a history of foot ulcers, or have had an amputation.

If you have a problem with your feet, be sure to talk with your GP or podiatrist. They can help; sometimes it requires them referring you on, if the special skills of a neurologist, vascular surgeon, or orthopaedic surgeon are needed.

                               Your feet mirror your general health . . . cherish them!