It’s Diabetes Awareness Week this week in New Zealand, so I am going to concentrate on Diabetes and the feet for the next few days.

People tend to think of diabetes as a silent, painless condition – but don’t tell that to the millions of folks with diabetes-induced tingling toes or painful feet. This problem, called diabetic neuropathy, can range from merely aggravating to disabling or even life threatening.

High blood sugar, the hallmark of diabetes, injures nerves and blood vessels throughout the body. The first nerves to be affected tend to be the smallest ones furthest from the spinal cord—those that stretch to the toes and feet.

Diabetic neuropathy affects different people in different ways. Some people will feel it as a mild tingling in the toes, while others have it much worse and suffer a constant burning feeling in their feet, or sharp, stabbing pains that may be worse at night with the feet becoming extremely sensitive to touch, making the weight of a sheet almost unbearable. It can be the complete opposite too, and entirely rob the feet of their ability to sense pain – which in itself can be very dangerous.

The truly scary thing about diabetic neuropathy is a 10-letter word we usually associate with horrific accidents or war time battlefields—amputation. When sensory nerves in the feet become damaged, a blister, cut, or sore can go unnoticed, allowing time for the wound to become infected. Infections that cause tissue to die (gangrene), and that spread to the bone may be impossible to treat with cleansing and antibiotics, and the only option may be amputation.

Protecting your feet:

So far, there is no cure for diabetic neuropathy, so the focus should be on preventative measures. The most important thing you can do is to keep your blood sugar as close as possible to your daily and longer-term targets. This can stave off the onset of diabetic neuropathy. It also helps keep foot problems in check. Other strategies include:

  • Control blood pressure: Like high blood sugar, high blood pressure damages blood vessels. This interferes with circulation to the feet, and contributes to nerve damage.
  • Stop smoking: Smoking interferes with blood circulation, and so compounds the effects of nerve and blood vessel damage.
  • Stay active: If you can walk or run, do it. If your feet hurt too much, exercise your arms and legs.
  • Slim down: For people who are overweight, losing weight improves the body’s ability to control blood sugar and it also takes some pressure off the feet.

Several prescription medications are available for treating diabetic neuropathy, but keep in mind that these drugs only treat pain; they don’t do anything to slow or reverse diabetic neuropathy. Non-drug options that work for some people include acupuncture, biofeedback, and transcutaneous nerve stimulation.

Check your feet:

If you have diabetes, your doctor or podiatrist should examine your feet at least once a year. In addition to looking for the obvious problems, he or she will check them for the loss of sensation. On the other 364 days, you should check your own feet. Look for blisters, cuts, cracked skin, ingrown toenails, or anything else that could give bacteria a window of entry to your body. Clean and treat any problem, and then keep an eye on it. If a wound doesn’t heal, see your doctor or podiatrist right away.

If your joints aren’t as flexible as they used to be, and you have trouble seeing the bottom of your foot, place a mirror face-up on the floor, hold your foot over it and voila—you can see the bottom without contorting yourself.