Dr K K Pandey
Have you noticed if you were a diabetic that you developed pain in leg and feet once you have walked for a distance, but pain disappeared the moment you stopped walking. You also might be suffering from tingling sensation in your toes and sole of the feet which may increase in intensity during winter season. You being a diabetic possibly might not be able to walk even for two hundred meters due to pain and above all, you fail to sleep during night because you develop pain in you leg and feet, once you lie down on the bed. You might have observed sometimes you suddenly got up from slumber and found you had pain in the feet, and once you sat up and kept your legs hanging from the edge of the bed, the intensity of pain dropped considerably. It may be possible you experience continuous pain in your feet and sometimes the pain becomes worst, and intolerable. If you suffer from any of there problems and your blood sugars are high, do not ignore it as the problem might become serious and may lead to loss of your feet. Without wasting time, you must consult a vascular or a cardiovascular surgeon and seek his advice.
Why feet of a diabetic are always at risk?
In diabetics, due to autonomic neuropathy (A.S.N.), the sweat glands and other lubricating glands lying underneath the skin stop working. This causes drying and hardening of skin, which invite early
Infection into the feet. This is exactly the reason why a diabetic patient develops foot ulcers very early and it becomes very difficult to control the infection once it has reached deep inside the foot. Sometimes, it may require an operation to make the ulcer heal.
Never allow a ‘corn’ to develop in your foot.
Neuropathy in a diabetic patient on one hand causes pain in the feet and on the other it raises the possibility of development of ‘corn’ in the feet if proper care of foot is not taken. Due to weakening of muscles of feet, the adjacent bones of feet are subjected to an unwarranted excess pressure. Due to continuous excessive pressure, the certain areas in the skin of the foot develop ‘corns’ in the feet. Once a ‘corn’ develops in the foot, a diabetic patient feels as if a pebble or a small stone is present inside the shoe. Due to this ‘corn’ in the feet of diabetics, pain becomes unbearable while walking.
Where a diabetic should go to if pain in feet occurs?
If you are a diabetic and experience pain in your feet while walking or you suffer from tingling sensation in feet while in bed during night time, you should immediately consult a vascular or a cardiovascular surgeon. It is very essential to know the exact reason for pain. Quite often people mistake it for arthritis or sciatica and go to a bone specialist for consultation. Sometimes a diabetic feel pain simultaneously in feet and back as well. In such a situation, one should never be careless because it means there is a significant and critical reduction in supply of pure blood to feet.
How to prevent pain in feet among diabetics?
If you are a diabetic patient, the first and foremost task is to control your blood sugar. The persistently uncontrolled high blood sugar level is a clear predictor of amputation of feet in future. A diabetic must walk for five to six kilometers daily in the morning. Daily morning walk on one hand ensures uninterrupted supply of pure blood to feet and on the other decreases the adverse effects of neuropathy on the feet. A diabetic should avoid dryness of skin of their legs and feet, as dry skin increases the possibility of developing cracks in the skin, which invite easy entry of bacteria into the feet. One can apply olive oil on leg and feet to avoid skin getting dried and dehydrated.
Foot care is very essential
One should always remember not to apply any kind of cream or oil inside the toe spaces. Never allow corn and hardened skin to develop in your feet. For this one has to wear comfortable, soft and well-cushioned shoes, and never put on shoes without a specialized silicone diabetic insole. These diabetic insoles have proved very useful in foot care and prevention of ulcers in feet. Special diabetic shoes are also available to wear inside the house but these should be worn only after advice of a vascular surgeon.
Never walk bare-footed
A diabetic patient should never walk bare-footed either inside or outside the house. One should not wear shoes without socks. One should always keep his feet clean and without moisture. A diabetic Diabetic insole is very useful in offloading the Special shoes like these help preventing ulcers pressure on foot: very important in diabetics in diabetic patients patient should keep consulting a vascular surgeon every three months for foot care and assessment of blood supply to his feet. If at any stage, blister or red patch appears on your foot, seek advice from a vascular surgeon without fail. A diabetic must avoid smoking and tobacco chewing, and at the same time alcohol intake should be restricted. Red meat especially mutton & beaf in a non vegetarian diet should be avoided.
(The author is Senior Consultant Dept. of Vascular and Cardio Thoracic Surgery Indraprastha Apollo Hospitals, New Delhi)
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