Sugar Matters
March 17, 2015
The creepy crawlies – Diabetes and your feet

Last night you got into bed and just as you started to relax, creepy crawly feelings started in your feet. Or BOOM, your feet jumped. Maybe your mate turned to you and said, “How long are you going to keep moving those legs, just go to sleep!” Sounds familiar?

Diabetes can affect the nerves in the feet in all kinds of strange ways, and this is what we will discuss today. It is referred to as peripheral diabetic neuropathy.{{more}}

The longer you have had diabetes, and the higher your blood sugars have been, then the more likely you will eventually suffer some kind of nerve damage in your feet and hands. Many people immediately think of numbness, which is one of the most dangerous, even though not immediately life altering. So what if you can’t feel everything on your feet, no big deal, right? Wrong, HUGE deal. I have had several patients who never felt the bruise on their toes, the cut along the side of the foot, or even the nail into the bottom of the foot (yes, an iron nail). Several days later something smelled, or they noticed some liquid in their socks. Guess what — infection. Most of those patients went on to have something cut off, either some toes or even the entire foot/leg. Once infection takes hold in the bones of someone with diabetes, it is very difficult to cure, even with months of antibiotics. Sometimes an infection progressed so quickly that the flesh just died, and it had to be cut off immediately before the rest of the body became sick from it. If you have numbness on your feet, please be sure to WEAR COVERED SHOES THAT FIT WELL. Do NOT go barefoot. And every night, EVERY NIGHT, examine your feet carefully. If there is any break in the skin, clean it carefully and see your doctor as soon as possible.

The other kind of diabetic neuropathy that gets folks’ attention is the painful, bothersome kind. Here are a few examples: feeling like ants crawling on your feet and legs, tingling, sharp shooting pains, burning, itching not relieved with scratching, and cramping in the feet. Any of these or combinations may signal nerve damage in your feet.

“Jumpy legs” are another example of nerve damage in diabetics. The medical term is restless leg syndrome, and in fact there are other causes, but diabetes is a big one. Those of you who have it can testify that it is very disruptive. People with restless leg syndrome are often chronically tired, because they never get enough sleep at night (their spouses also get little sleep since it keeps them awake too!).

There are medications available to treat various diabetic neuropathies and restless leg syndrome. All of these, as well as the numbness, can improve if your blood sugars are brought down to normal. However, for many people, their sugars have run high for too long, so the damage may be permanent. As always, talk to your doctor; he/she will determine the best medications, if appropriate. YOUR job is to work on bringing your blood sugars down and keeping them down.

Take care of those feet. They have lots of places to take you in future.

Until next week, stay safe and healthy Vincies!

Anita Ramsetty, MD

Medical Director Endocrine Care Group

Tel: 843-798-4227