FAIRFIELD-SUISUN, CALIFORNIA

The Other Side of 50

How to keep diabetes from damaging your feet, ankles

By From page OSF2 | May 08, 2014

Diabetes. This can be construed as a bad word in today’s society. For many baby boomers, it is a common problem that is often neglected or undertreated, and can lead to serious foot and ankle problems.

Here are some insights into the disease and ways to prevent problems, specifically with your feet, if you are over the age of 50.

According to the National Institute of Health, diabetes affects 25.8 million Americans in 2014. That is 8.3 percent of our population, and 7 million of these people do not know they have the disease. This is a staggering statistic when you think about how the untreated disease can affect your health.

As a podiatrist, my job is to help prevent the foot and ankle problems that diabetes can cause. I focus on three basic tenets of care with my patients. The first is helping them understand the disease in general, including why and how the disease works with their physiology. Second, I share how diabetes can affect their feet and how to recognize dangerous signs and symptoms. Lastly, I focused on prevention of the long-term effects.

Diabetes is a disease of the endocrine system that affects how your body uses blood glucose, commonly called blood sugar. Glucose is a vital source of energy for the cells that make up your muscles and tissues and for your brain. If you have diabetes, you have too much glucose in your blood, which can lead to serious health problems. The disease is treated with either oral medication or insulin.

Manifestations of the disease in the foot and ankle can have an insidious onset, and can affect all four basic systems. Vascular, dermatologic, neurologic and musculoskeletal problems are commonplace when diabetes is left untreated or unchecked. Peripheral neuropathy, described as the abnormal function of peripheral nerves as a result of diabetes, is a problem for many people older than 50. It often causes weakness, numbness and pain in your feet. You may feel tingling or burning, or a loss of feeling. Typically we see an increase in peripheral neuropathy in patients after five to 10 years with the disease.

Skin issues are also very prevalent. Diabetic foot ulcerations and wounds usually develop as a result of friction, usually caused by shoe wear. These can be life-changing if infection occurs. I spend many nights in the emergency room handling these types of wounds, often having to remove the infected nonviable tissue. Diabetes is the cause of 60 percent of the lower extremity amputations in the United States.

My main focus with diabetic patients is on prevention. Careful and close follow-up with your primary care physician, endocrinologist, dietitian and podiatrist can prevent serious complications. I ask my patients to:

  • Look at your feet twice a day. It can prevent problems from occurring.
  • Wear the proper shoe gear. There are multiple brands of diabetic shoes that have a wide toe box and can prevent the pressure and friction that causes diabetic wounds.
  • Take your medication as prescribed. This is very important, and is something you will hear from every doctor that you visit.
  • Eat a diet consistent with American Diabetes Association recommendations.
  • Get some exercise.
  • Most importantly, visit your podiatrist every two to three months for a complete examination of your feet. This could prevent any major issues from occurring and will only serve to help keep you moving forward into the “golden years.”

Dr. Kevin Miller is a podiatrist with the NorthBay Foot & Ankle Medical Group in Fairfield and Vacaville.

Dr. Kevin Miller

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