Feet on Fire: The Diabetic Epidemic

Have you ever been burned by a hot pan? Most of us have, but can you imagine having that feeling from your whole foot, persisting, without let-up? That is what some diabetics have to endure. It’s called diabetic neuropathy, and many individuals with diabetes have a greatly reduced quality of lifebecause they suffer from this problem. It all stems from the imbalance in glucose metabolism that is seen with this disease.

Glucose is “just” sugar, but any substance in large enough quantities can act as a poison. Various theories exist as to the exact mechanism, but regardless, nerves stop working correctly when sugar levels rise high enough, and for long enough. Numbness is the most common sensation experienced, but there can also be tingling, “pins and needles”, or the aforementioned burning.With diabetic neuropathy, this fiery feeling develops first in that part of the body farthest from the heart. Obviously, that body part is the toes! This is due to the fact that neuropathy is a “length dependent” process, which means that the longer the nerve is going to some part of the body, the more chance it has to be affected by the disease. Naturally, that means the toes and front of the foot are the “hottest”, and most lacking in sensation. One might think this numbness of little consequence other than producing an unpleasant burning, but, in reality, the effects can be disastrous. When an area of skin is without sensation, it can not report localized problems to the brain, which is one of the most important functions of nerves. Pain is a very beneficial feeling: it tells a person that they have a problem, and something needs to be done. The affected individual will try to stop the events leading to this signal. This may mean limping, trying new shoes, or perhaps a visit to the emergency room, but whatever one does, pain typically elicits a change in behavior.

Ever wear a pair of shoes that are too tight? Not for long!! But without pain, an individual with this type of neuropathy would continue to wear them. With sufficient repetitive irritation, the skin will break down and the tissues beneath will be exposed. Perhaps the most important job of your skin is to act as a barrier. When it breaks down, our most vital barrier to bacteria is lost. This is the reason more diabetics have an amputation of a foot or leg than any other population group. If a diabetic is not “on guard”, a simple ingrown nail can lead to loss of a limb, and largely because of the very nasty infections that occur without an intact skin layer.  It certainly doesn’t help that many diabetics experience reduced circulation, which decreases the number of blood-borne cells that fight infection. The last piece of the puzzle is immunopathy, a decrease in the viability of certain cells, whose function is to fight off various types of bacteria.

Burning and numbness are just part of the constellation of conditions that diabetics deal with. Many others exist, affecting various structures and organs. Regardless, diabetic foot problems are, without a doubt, one of the most common and potentially disabling results of this disease. In a nutshell, the key for those afflicted with diabetes is simple. Be “sweet” to your feet, and treat them well. Be observant for new problems, especially to those areas where they most commonly develop. Keep your skin healthy and well hydrated. Also, GET TREATMENT EARLY, before a minor problem becomes a big problem, and much more difficult to treat. Early on, a developing condition is generally easy to resolve, but with time, a “cure” may be impossible to achieve. If you

have diabetes, attend an introductory educational session for those recently diagnosed. Since the number of people that have diabetes is rising steadily, get checked. Many have it, but don’t yet know it!

So if you have this common condition, get educated. THE MORE YOU KNOW, THE BETTER YOU WILL DO!