Juvenile Diabetes and Your Feet

Type I, or juvenile diabetes, is usually diagnosed during childhood or early adulthood. Type I diabetics do not produce insulin; this is the hormone that converts sugar to energy. Type II diabetics or adult-onset diabetes do not produce enough insulin or use the insulin efficiently. A type I diabetic requires insulin to be administered as part of their treatment while a type II can see improvement through changes in diet, exercise as well as with oral medications.

Diabetes, whether juvenile or adult-onset, are at greater risk of developing complications regarding their health. This can effect the heart, eyes, and kidneys just to name a few. These problems can also manifest in the feet. Diabetics can develop nerve damage or neuropathy. This is a loss of sensation where you may not feel pain, heat or cold. If you can't feel your feet, it is possible to develop an injury, but not recognize it has occurred until the symptoms worsen.

The skin can also become very dry and crack or peel. Regular application of moisturizer cream can help, but avoid applying this in between the toes. Excess moisture in between toes can lead to fungal infections. Calluses are thickened areas of skin that develop because of a high pressure point. If not properly cared for the callus can break down and become an ulcer. Ulcerations are open wounds that can potentially become infected and put the foot or limb at risk of amputation.

Diabetics are also at risk of developing poor circulation. The blood vessels can harden and narrow which prevent blood from adequately flowing. Smoking increases the risk of this complication. Some people will experience pain when walking because of impaired circulation.

Poor circulation and lack of sensation can be a dangerous combination for the feet, but it is possible to prevent these complications. It is necessary to maintain good blood sugar control and exercise regularly to help decrease the chance of developing complications from diabetes. Regular foot exams can also help prevent these complication or provide the necessary treatment if they have already developed.

Is this burning foot pain a neuroma?

Have you experienced a sharp or burning pain to your toes? Maybe you've felt like your sock was bunched up in your shoe, but when you looked, nothing was there. You could be experiencing the pain of a neuroma. This is a thickening or enlargement of a nerve due to compression and irritation. The most common place to experience this is in between the third and fourth digits of your foot.

What causes a neuroma? Wearing high heeled shoes or shoes with a narrow toe box that cause the toes to be pinched together can lead to these symptoms. Those people with hammertoes, flatfeet, or those who have repetitive stress to the ball of the foot from sports can also develop a neuroma.

There are multiple treatment options available try and alleviate the pain of a neuroma. Padding techniques can help decrease pressure to the painful nerve. Custom orthotics can also help achieve this goal. Avoiding narrow shoes and high heels is also helpful. Try to wear shoes with a wider toe box. Anti-inflammatory medications and injection therapy can also reduce pain. Some patients will go on to have surgical removal of the neuroma if there is not adequate response to conservative treatment. Discussion of your symptoms with your podiatrist can help determine which treatment is best for you.