In the days before modern medicine, someone who lived long enough with diabetes may have had one or both legs amputated. I assumed it did not happen anymore, until I read about people with diabetes who have ignored high blood sugar levels and developed complications requiring amputations.
It seemed impossible that this could still be happening. Then the pain and numbness in my own feet sent me looking for answers. What caused it, and what could I do about it?
I learned that the path from high blood sugar to foot ulcers and amputations often goes through a condition called peripheral neuropathy, the medical term for nerve damage in the hands, feet, arms, and legs that often causes pain and numbness.
Diabetes and nerve damage
High blood sugar damages blood vessels. One doctor described the extra glucose floating in the blood of someone with diabetes as similar to bits of glass scraping along the walls of veins and arteries.
The tiniest blood vessels are easily damaged. That is why eyes, feet, and kidneys are so vulnerable, showing signs of blood vessel damage, sometimes even before a person is aware he has diabetes.
Fingers and toes can become numb or overly sensitive when the blood vessels that supply the nerves are hurt. The longest nerves in your body run down your spine into your feet, ending at your toes. This makes feet an easy target for damage from peripheral neuropathy.
Feet with nerve damage
Because of diabetes we must care more about issues like foot ulcers, infections, ingrown nails, toenail fungus, and sores. The greatest enemy to our feet is numbness, because pain is the thing that warns us something is wrong.
Peripheral neuropathy may make your feet more sensitive to touch while at the same time the numbness it may cause can mask problems like hot spots that are forming from shoes that are too tight or loose. A person who has had Type 2 diabetes for many years may step on a nail and carry it around in his foot without being aware of it, even though his toes are so sensitive he cannot stand a bedsheet touching them.
This is the reason your doctor should examine your feet and legs at every visit. It is also why you ought to find a good podiatrist, or foot doctor. Aging with Type 2 diabetes may mean developing complications from nerve damage, and you need all the help you can get.
Weapons against nerve damage
Here is the good news: There are things you can do to prevent and even stop nerve damage in your feet. Your first and best defense against peripheral neuropathy is to lower your blood sugar levels.
The main reason doctors want you to have a hemoglobin A1C below 7% is this: If your numbers are lower, you will have fewer complications from diabetes. Studies have proven it. Lower blood sugar means less damage.
Another great weapon is exercise. Using your legs and feet encourages blood flow, and that keeps nerves healthy. I have experienced this myself as I have become more active. Swimming, biking, walking, gardening, cooking — anything that makes you move around will protect against peripheral neuropathy.
Third, inspect your feet every day. It is a direct way to lower your risk of amputation. Orthopedic surgeons say this one thing could have saved huge numbers of feet among their patients with diabetes.
Why is foot inspection so helpful? Because foot ulcers are most often the initial cause for a lower-extremity amputation in people with diabetes. Since we may have nerve damage, we must use our eyes to find problems in our feet.
Tighter blood sugar monitoring and daily inspection are the two things health professionals point to when they see lower amputation rates today. It is true that amputation is no longer something you have to accept as part of your future.
People with Type 1 and Type 2 diabetes are living longer. We are also living with the complications for many more years than the generations before us. So guard your feet, and do not take them for granted.