Senses play role in guiding those suffering from ‘diabetic neuropathy’





By Michael Zapf, DPM

Remember walking through a House of Mirrors at a carnival? It was very disorienting. You were never sure of what you were looking at. To navigate the maze, you’d start to rely on other senses, like touch, instead of just your eyes.


Diabetes is similar to that House of Mirrors. Without the sensation of pain as a guide, you never know exactly what you’re looking at or what you’re feeling.


Those of us without diabetes know immediately when we step on something sharp or injure our foot by locating living room furniture in the dark. Many patients with diabetes aren’t so lucky. They’ve lost feeling in their feet, a condition called neuropathy that occurs if a patient’s blood sugars are too high for too long. They’re deprived of the ability to feel pain.


A patient with neuropathy doesn’t heed the early warning sign of pain and instead continues a particular activity, such as using a treadmill, until a bone actually breaks. They might notice some swelling and redness, but the lack of pain frequently causes them to discount their injury until it becomes disabling.


A similar process happens with a simple blister or break in the skin. A patient with diabetic neuropathy will often deny that it’s a problem because it doesn’t feel like a problem. In more than one case, the patient ends up in my office because a spouse notices blood on the socks or rug.


Instead, people living in the "House of Mirrors" of diabetic neuropathy need to rely on other senses—their eyes for example. A simple plea to all people with diabetic neuropathy: if it looks like it might be a problem, it is a problem.


If you or someone you love has diabetic neuropathy, please follow (or have them follow) these guidelines:


1. Always wear closed shoes and always inspect them with your eyes and fingers before putting them on. Sandals and slippers give some protection from the ground, but they still let rocks, staples and straight pins slip in from the side.


2. Sweaty feet are more prone to blisters and breaks in the skin. If your feet sweat a lot, change your socks often and avoid wearing the same pair of shoes two days in a row.


3. Medicare will pay for a pair of shoes every year for every diabetes patient who’s at high risk. Some other insurance plans also pay for shoes for diabetic patients. If you’re a Medicare patient with diabetes, ask your podiatrist if he or she can supply these shoes.


4. Inspect your feet once a day for any blisters, breaks in the skin, redness or swelling that wasn’t there the day before. Show any that you find to your podiatrist or your family doctor. Don’t ever try to treat these yourself.


5. If your eyesight prevents you from seeing your feet clearly, have someone with good eyesight check them frequently. If you’re not nimble enough to see the bottom of your feet, prop a mirror on the floor near your toilet and inspect them when you’re seated.


6. Refrain from bathroom surgery for ingrown nails, calluses, corns and blisters. Let your podiatrist treat these problems.


7. If you have neuropathy or other problems that make you high risk, visit your podiatrist once every two months for nail and callus care and a general foot inspection. At these visits your pulse and nerve status will be checked.


8. If you have diabetes but aren’t yet high risk, the American Diabetes Association recommends that you visit your podiatrist annually.


9. Keep your blood sugar under as good control as you can. Eat correctly and exercise regularly.


10. Join the American Diabetes Association, (800) 342-2383, and learn as much as you can about the disease.


Dr. Michael Zapf is a podiatrist serving the Conejo Valley since 1985 with offices in Agoura Hills and Thousand Oaks. He’s a member of the American Diabetes Association. For more information, please call his office at (818) 707-3668.



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