Diabetic Foot Ulcers- Their connection to neuropathy?

According to the CDC, almost 24 million Americans have diabetes. That is merely an estimate! And, in addition, it is reported that about , six million of those individuals are undiagnosed. Along with diabetes, there are several other complications that may lead to serious conditions, including diabetic foot ulcers.

Patients with diabetes have a 15%-25% lifetime risk for developing a foot ulcer. Why and how does this happen? One of the common findings in patients with diabetes is diabetic neuropathy. This may manifest itself in the form of tingling and numbness in the fingers and toes. In the foot, patients describe the feeling of neuropathy as sharp shooting pain, tingling, burning, or just plain numbness. Due to the lack of sensation, an area of increased friction due to a bony prominence or an ill fitting shoe can easily break down the skin. In a person without diabetes, the breakdown of skin can be a blister or corn or callus and the person would feel pain. The pain would signal the nondiabetic person to remove their shoe, inspect the wound, or seek medical help. However in a diabetic patient with neuropathy, he or she is unable to feel any pain, blistering, or infection until is too late. An open sore forms, or an ulceration, and in this case, when an ulceration occurs, the risk for infection is present and may range in severity from a superficial area to one that pervades the bone. Infection is the leading risk factor for amputation among those with diabetic foot ulcers.

So please, if you are diabetic, seek help from a foot specialist. For example at our clinic, Prairie Path Foot and Ankle Clinic, we take pride in serving our diabetic patients with the utmost care. Your primary care doctor should check your feet at every visit, and you as a patient should be checking your feet daily as well. A visit to our office will put you at ease and answer any questions you may have about diabetic foot care and prevention. Leave your feet it in our hands!

Diabetes and Chocolate?

With the Easter holiday upon us, everywhere you turn its candy, candy, candy... especially chocolate. Many of my patients ask me, can diabetes and chocolate mix?

With so many consumers suffering from diabetes, there has been a great deal of discussion about which foods are OK and which ones are forbidden. As with all simple sugars, those patients with diabetes may enjoy an occasional chocolate treat if they exercise restraint and moderation. According to dieticians, the sugar in chocolate is absorbed more slowly than that found in many often consumed foods, such as white bread and even mashed potatoes. However when consuming chocolate, if it is part of a meal or as a small dessert, the food already in your stomach may delay the absorption of the sugar, and may slow the rise in blood sugar vs. if you eat chocolate alone or on an empty stomach. This means that the body has a bit more time to deal with the rise in blood sugar caused by sugar in chocolate. It is important to keep in mind, however, that too much chocolate can lead to obesity, which is a complicating factor for diabetics.

What about special "diabetic" chocolate? This type of chocolate is made with sorbitol, which is a sugar alcohol. If eaten in excess, side effects may include laxative effects or cramping. While the diabetic chocolate is designed to not raise blood glucose levels, it still has plenty of calories, and it is important not to think of this special chocolate as a license to overeat.

So the bottom line is this - whether you eat chocolate or not, as a diabetic, the key is to eat in moderation. Ultimately, checking with your doctor or dietician can determine whether you can safely eat traditional chocolate or "diabetic" chocolate with sorbitol. The most important fact to take away from this is that it is of the utmost importance to discuss your diet, chocolate or not, with your endocrinologist, diabetes educator, dietician, or primary care doctor. No one dietary plan will be right for every patient, and open and honest communication with the doctor is one of the best ways to avoid the complications that may result from having diabetes. They may have further insight into recommendations, and yes, you have to take their word for it if they determine that chocolate may not be right for you.