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!

Simple Home Diabetic Foot Exam

As a diabetic, it is important that you do a diabetic foot exam on your feet every day. First of all, as a diabetic, you should have a relationship with a podiatrist, or foot and ankle specialist, and he or she should have good communication with you and your primary care physician. As a team, the three of you can keep your diabetic feet healthy. Here are a few of the basic recommended things you can do at home to help with your diabetes foot care.

Daily foot exam: Take a look at your feet every day, top and bottom. It may be helpful to take a hand-held mirror and look at the bottom of your feet as well. You need to examine your feet every day and after any trauma you may experience no matter how minor you think it is. Trauma is just a fancy word for any sort of physical injury or bump to your feet. Tell your podiatrist about anything like this that happens.

Foot Cream: apply a moisturizing cream on your feet every day on the top and bottom of your feet, but never between your toes.

Socks: Avoid wearing tight elastic socks or nylons. They can cut off or impair your circulation without you being aware of it. Wear cotton or wool socks instead. Nylons can cause shearing and they trap moisture and do not allow your skin to breathe.

Clear the Area: Make sure the area where you walk is clear of clutter. get any items you're likely to trip over or bump into out of the way.

Footwear: Make sure to wear sturdy and comfortable shoes wherever possible to help protect your feet. You may qualify for diabetic shoes through the Medicare shoe program. At Prairie Path Foot and Ankle clinic and Schaumburg Foot and Ankle clinic, we are certified to fit our qualifying patients with Dr. Comfort brand shoes. Please visit our office in Elmhurst or Schaumburg Illinois to see if you qualify.

Taking these simple measures at home along with a comprehensive plan of diabetic footcare and surveillance with the help of your podiatrist will keep your feet healthy, and will keep you active and healthy.

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!

Over the counter orthotics in diabetics?

I saw a patient today who received orthotics, or insoles, from a shoe store. She was told that these were "custom"; however, there was really nothing "custom" about them! They were not prescribed by a podiatrist, and the material was not accomodative and instead quite rigid and uncomfortable. And the worst part about it was... the shoe store had labeled the orthotics wrong! The left foot orthotic was in the right shoe, and vice versa. Thank goodness there were no immediate ill effects with the wrong orthotics in the wrong shoe, but this could be potentially detrimental.
So, bottom line... when choosing orthotics, there are several things to keep in mind as a diabetic. The best option is really custom made orthotics made per your prescription from a podiatrist. This way, you know that your podiatrist has done a thorough exam and has accounted for all the issues with your foot, including possibly bony deformities and diabetic neuropathy, which will prevent you from getting sores. In addition, your doctor can determine if diabetic shoes are for you in addition to the custom insoles. Another option if the custom orthotics are not possible is a good semi-custom orthotic that can be purchased and accommodated by your podiatrist. The most important thing is to get your feet examined and checked often, in order to stave off potential foot problems.

Socks and more socks!

Have you seen the latest trend in socks? The latest I heard about are these expensive "socks to the stars." It is now known that 36% of women have no problem spending over $25 on a pair of socks for fashion. Does that seem like a lot? The designer company, Rodarte, is manufacturing a sock that costs upwards of $500. This is one pair you don't want to lose in the dryer! These $500 multicolored hand-crocheted socks are made of silk mohair yarn and soft alpaca wool. Can you say dry clean only?

As a diabetic, you don't have to spend upwards of $25 for a good pair of diabetic friendly socks. Our office sells diabetic socks that have no seams, and have a graded elastic so it does not irritate the skin. Also, we advise our patients that it is not essential, in fact it is not preferable, that diabetics use socks that are 100% cotton. Think of a wet T-shirt, how it holds moisture and causes chafing on the skin. The same thing happens with feet when they sweat. If the socks are 100% cotton, more chances for retaining moisture, causing blistering, and increased chance for athletes foot or fungal infections. The best material for socks is one that is a cotton blend with another material such as polyester or nylon, on even a "dry-weave" that will wisk moisture away from the skin.
So don't ever feel that you have to spend big bucks to get proper socks for those diabetic feet. And you'll be able to wash them.

Diabetic Shoes

A patient asked me, "What kind to shoes should I be wearing as a diabetic?" For the answer, there are a few guidelines to follow. The best thing to do first is to see a podiatrist and have your feet evaluated. Not only will you get a thorough exam, but you will also receive invaluable information and education about your feet and the structure of your feet. In addition, many podiatrist offices like ours, Prairie Path Foot and Ankle Clinic, are certified to fit and dispense diabetic shoes such as Dr. Comfort brand, if you qualify per Medicare standards.
For those patients whom that is not an option, then there are several qualities to look for in a shoe. Firstly, it should have a wide toe box. This is in order to accommodate any foot structural deformities, such as bunions or hammer toes. This would prevent any irritation against the skin that could turn into an ulcer or an open sore.
The next thing to look for is good padding along the sole of the shoe. Some have extra cushioning in order to accommodate any bony prominences or areas of increased pressure, again, to prevent a sore from forming. In addition, the shoe should be easy to adjust with laces or velcro, in order to take into account the fact that the feet may swell at the end of the day, and the shoe can easily expand.
Most importantly, until you are confident that your shoes are well fitting and free of risk, you must break in your shoes. Wear them a couple of hours a day, and slowly increase until you can wear them all day. Be sure to check your feet for areas of redness and irritation, and if you do find this, take the shoes back to where you purchased them and schedule an appointment to have your feet examined again by a podiatrist to make sure no new sores or ulcers have occurred.
Please stop by our office at Prairie Path Foot and Ankle Clinic and see our line of Dr. Comfort diabetic shoes. After a thorough diabetic foot exam, our Certified Podiatric Medical Assistant will be happy to assist you in picking out a pair of shoes. Happy Walking!