Dear Dr. SerVaas,
My feet hurt and feel swollen inside. They get worse when I lay down. I am a diabetic and on Glucotrol, Glucophage, and insulin. My sugar count still runs above the 120 limit. Is there anything I can do for my feet?
It is very important for you to inspect your feet once or twice daily for any signs of injury or infection. Experts at Joslin Clinic also advise diabetics to wash their feet every day in warm water with mild soap, dry thoroughly, and use an approved moisturizer. Left untreated, a small sore can have serious consequences.
We asked Dr. Edgar Ross, who is the director of the Pain Management Center at Brigham and Women’s Hospital in Boston, about treating foot pain related to diabetes. Dr. Ross replies:
“Diabetes can have many complications associated with it. One of the most common and debilitating complications is a condition called diabetic peripheral neuropathy (or DPN).
“Over time, elevated blood sugars from diabetes can damage nerves throughout the body, and this process usually begins in the feet. Although there are exceptions, DPN symptoms are often slight at first. The pain may gradually worsen and feel very much like what you describe.
“Research shows that improved blood sugar control delays the progression of DPN, and it is important that people are diagnosed early and receive aggressive treatment. Doctors estimate that nearly half of the amputations in the U.S. are caused by neuropathy and poor circulation that could have been prevented by careful foot care. Therefore, regular foot exams to look for loss of sensation are critical, as patients may not be able to feel pain, especially in the feet—a problem that can lead to potentially dangerous and unrecognized injuries.
“Healthcare professionals (e.g., a specially trained nurse, podiatrist and/or physical therapist) may recommend special footwear to help people with numbness in the feet avoid injury.
“In addition, several medications are proven to help manage pain from diabetic neuropathy. Newer anticonvulsant medications such as gabapentin and pregabalin have been shown to be particularly effective, so talk to your doctor about what is right for you.
“About half of all people with diabetes develop DPN. In advanced cases, patients may experience tingling and burning in the feet and even the arms.”