Peripheral neuropathy: Understanding diabetes effects on your feet

What do you think when someone mentions diabetes? High blood sugar. Insulin shots.

How often do you think of diabetes effects on the feet? The more common places you see complications of diabetes are in your eyes, kidneys and feet. 

According to the American Diabetes Association, more than 29 million Americans have diabetes and another 1.4 million cases are diagnosed each year. More than 73,000 amputations were performed in 2010 due to diabetes complications. However, it is estimated that up 85% of all amputations due to diabetes can be prevented through regular inspection of the diabetic foot.

“Nowadays when you get diagnosed with diabetes, usually your primary care doctor will set you up with an eye specialist, test your kidney function and send you to see a foot and ankle specialist,” says David Valbuena, DPM, podiatrist and board-certified ankle and foot surgeon with Georgia Foot and Ankle Institute in Savannah.

One of the most common complications of diabetes that could lead to amputation is peripheral neuropathy. Peripheral nerves carry information from the brain and spinal cord to the rest of your body. Peripheral neuropathy occurs when these nerves are damaged or diseased, causing weakness and making it difficult to control muscles typically in your hands, legs and feet. Chronically high blood sugar levels are a cause of peripheral nerve damage.

As it relates to the feet, peripheral neuropathy affects two sides of the nervous system – sensory and autonomic, Valbuena says. On the sensory side, a patient may experience loss of feeling which can lead to ulcerations, sores and debilitating pain. On the autonomic side, it can cause calcification of arterial vessels and may lead to peripheral vascular disease, which involves a vascular surgeon.

Between 60 and 70 percent of all people with diabetes will eventually develop peripheral neuropathy; however, the condition is not inevitable.

“The best way to prevent peripheral neuropathy is keeping your diabetes under control,” says Keith Rouse, DPM, podiatrist and board-certified ankle and foot surgeon with Georgia Foot and Ankle Institute. “It also can be prevented by routine diabetic checkups. That’s key.”

What does peripheral neuropathy feel like in the feet?

In the beginning stages of peripheral neuropathy, a patient may feel like they have an extra sock on or experience restless leg syndrome, says Rouse. Some people may feel like they can’t stretch their feet or their feet may feel really tight even though they aren’t, Rouse adds.

Symptoms increase in severity to sharp, stabbing pains and a burning sensation in the feet. Sometimes, a patient may feel like they have ants crawling up and down their feet even though there’s nothing there, Valbuena says.

Some diabetics may not feel heat, cold or pain in their feet, which could lead to ulcers and sores and, if untreated, potentially lead to amputation. That’s why it’s important for diabetics to check their feet daily and have routine visits with their podiatrist.

Podiatrists routinely see diabetes patients to try to prevent or help treat peripheral neuropathy. Valbuena says he and Rouse will see diabetic patients sometimes every two months and sometimes just the recommended once a year depending on a patient’s condition.

There is no cure for peripheral neuropathy but you can treat the symptoms through medication, proper shoe wear, inserts, physical therapy and most importantly maintain your diabetes properly. 

Click here to learn more about Georgia Foot and Ankle Institute.