Bare Feet + Diabetic
Tales of a Barefoot Diabetic
It has long been known that one of the most common pedal side effects in a diabetic patient is peripheral neuropathy which manifests into a loss of protective sensation in the feet and lower legs. The symptoms of diabetic neuropathy can be described in many different fashions, including burning, tingling, numbness, stiffness, as well as many other descriptions.
However, one thing remains true of all patients suffering from diabetic peripheral neuropathy – they are at increased risk of pedal complications due to their lack of sensation. Complications can arise when insensate patients walk barefoot around their home or outside. Due to the inability to feel sharp things on the bottom of their feet, patients can step on any number of things (glass, splinter, metal object) and not even know it. The area can become infected and lead to a much deeper infection if the injury is not quickly identified and treated. Often times a patient will not be aware they stepped on something until blood or drainage is noticed on a sock or slipper.
The following is a very common case presentation of a neuropathic:
An 82 year old diabetic male with peripheral neuropathy presented to our office with complaint of drainage and blood noted to his sock. He denied any pain, as well as any signs of systemic infection such as fevers, chills, nausea or vomiting. He said that if he had not noticed any of the drainage on his sock, he would not have known anything was wrong. After examination, the patient had a small puncture wound in the area of concern with surrounding blister and subdermal hemorrhage (bleeding) formation noted. Following debridement of the area, a small piece of glass was removed from the patient’s foot.
Luckily, the patient acted quickly by presenting to our office as soon as he noticed the problem, allowing for prompt assessment and treatment before any aggressive measures (such as amputation) was required.
Unfortunately, sometimes these issues can progress towards amputation because neuropathic patients do not always act quickly enough. If infection is not noticed quickly, it can spread rapidly. If infection goes deep enough and reaches bone, the indicated treatment is amputation of the associated bone.
For these reasons, daily foot exams in the neuropathic diabetic patient can be critical!
Dr. Jennifer Sartori is a podiatrist working out of our Portsmouth & Nashua, NH locations. She is currently accepting new patients. If you would like to request an appointment with Dr. Sartori please go here – Appointment Request