Diabetes is a complex disease that affects many different organ systems and parts of the body. In particular the legs and feet can develop serious complications that could ultimately lead to amputation in the worst cases.
Common problems that occur in the feet are PAD (poor circulation) and Neuropathy. These conditions often arise in patients whose sugar control is poor, or those that have had diabetes for a long time( over 10 years).
PAD, otherwise known as poor circulation means that a person bas developed decreased blood flow to the muscles, tissues and skin of the feet or legs. Many people as they age develop poor circulation due to cholesterol deposits in their arteries (the blood vessels that bring the blood to all parts of the body). However, diabetic patients also have the additional problem where their small blood vessels in their feet develop s low blockages over time from the effects of the diabetes. This puts a diabetic in a much higher risk group. With decreased circulation small cuts do not heal properly, and serious wounds called diabetic ulcers can result.
Neuropathy refers to several problems with the nerves of the feet. Small nerve fibers are often damaged over time in diabetics. This can lead to symptoms such as Numbness (diminished feeling or loss of sensation), Burning pains, or Paresthesias (tingling or pins and needles sensations). In addition neuropathy can lead to muscle weakness of the smaller muscles of the feet. When this occurs there is an increase in foot deformities that will develop such as hammertoes, bunions, and plantar flexed (dropped) metatarsal bones. These can all lead to diabetic ulcers.
In our office we perform a CDFE(Comprehensive Diabetic Foot Exam) on all our new patients, and on those who complain of new symptoms when they are seen in the office. By evaluating the circulation, nerves, bones and joints, and the skin of our diabetics we can often detect potential problems before they have a chance to cause a serious complication.