Why are my toes tingling?

I see many diabetics in my practice, and many are very well informed about their process, and prognosis. However when we speak about foot problems and complications, frequently patients ask why their toes are tingling, burning, or sometimes feel numb. Other complaints include the complete opposite, such as hypersensitivity. Very often the answer to these questions is diabetic peripheral neuropathy (DPN).

DPN is one of the most common side effects of diabetes. The longer a person has diabetes, the more the risk of developing neuropathy. Some recent studies have shown that up to 60% of diabetics have neuropathy. What causes it? Elevated blood sugar causes chemical changes in the nerves. These changes do not allow the nerves to transmit signals effectively, causing decreased feeling, imbalance and instability of gait with increased risk in falling, and the ability to feel sensations different in different parts of the body, especially in your feet and toes.

In order to treat the symptoms, it is important for proper diagnosis. Ways your podiatrist can diagnose diabetic peripheral neuropathy include a monofilament test, nerve conduction studies, nerve biopsies, and quantitative sensory testing.

Treatment may include blood sugar control, oral prescription medications, topical medications, and even a product called Neuremedy which can be dispensed right in our office. Speak to one of our podiatrist to find out if this supplement is appropriate for you.

By seeing a podiatrist and getting a thorough exam, you can get help with diagnosing and treating diabetic peripheral neuropathy. Visit us at elmhurstfootdoc.com or stop in our office in Elmhurst, IL and speak to Dr. Arain or Dr. McNeill. Your tingling toes will thank you!

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.