What is a Diabetic Foot Exam?
Why Do I Need One?
Diabetes can affect the feet in several ways. Three important things we look at during a diabetic foot exam include circulation, nerve function and deformity. Let’s look at each one in greater detail.
Circulation
Diabetes can have a negative effect on circulation throughout the entire body. This is often manifested by a heart attack or stroke. At the same time, the arteries that carry blood to your feet can start to narrow as well. This can cause a condition known as intermittent claudication. In this instance, not enough blood is getting to the muscles of the legs which then results in heaviness, cramping or pain. This can occur in the buttocks, thighs, or calf muscles. Keep in mind that these are more advanced symptoms and that narrowing of the arteries has been occurring long before this pain is felt.
Neuropathy
This is when the nerves are not functioning well or “dying off.” We will look at this in greater detail in future blogs. Neuropathy can result in pain and numbness at the same time .In more advanced stages, people will say their feet feel like leather or that they always have socks on. The danger of this is that you lose your “gift of pain.” Pain is our body’s way of telling us we have a problem that needs attention. If you have severe neuropathy and you sustain an injury (say for example your shoe rubs on your baby toe) you may not do anything about it because you don’t even realize it’s happening! Eventually this can lead to an open sore called a diabetic ulcer. This is why we emphasize inspecting your feet daily for red spots of any signs of irritation.
We have simple tests that we can do during a foot exam that can detect neuropathy in an early stage. If discovered, there are ways to improve or prevent progression of the damage.
Deformity
Deformity is defined as anything that deviates from the normal. In the foot that can include crooked toes (hammertoes), bunions, prominent bones in the ball of the foot that cause abnormal excess pressure, and others. Anything that may cause rubbing on a shoe or increased pressure (hotspot) qualifies as a deformity. These areas need special attention with possible a shoe modification or padding to decrease the pressure of friction.
These three components make up the formula for a diabetic foot ulcer (sore). An example would be a hammertoe that rubs on the top of the shoe. This is what is called microtrauma. A small insult over time that results in a corn or ulcer. If you add neuropathy, you may not notice anything until one day you wonder why you have blood on your sock. That is why it is recommended for people with diabetes to visually examine their feet daily for any red spots or other abnormalities.
