Diabetic patients should not ignore pain and tingling in their feet.

Dr. K.K. Pandey
Senior Vascular and Cardiothoracic Surgeon
Indraprastha Apollo Hospital, New Delhi

Diabetes Problems: If you are a diabetic patient, then it does not happen that after walking a short distance, pain starts in your feet and legs, but when you stop, the pain disappears. It may also happen that you experience constant tingling in your feet, fingers and soles, which increases especially during winter. Sometimes it may happen that it is difficult for you to walk even a single step, and even more so, you may experience pain in your legs and feet while lying in bed at night, due to which you are not able to sleep properly at night. Sometimes it may have happened that suddenly you woke up and found that you were having pain in your legs. If you sat with your legs hanging or walked for a little bit, the pain reduced. It may also happen to you that there is pain in your legs all the time and sometimes this pain becomes unbearable. If you are suffering from any one of these problems and you are a diabetic patient then do not be careless at all because the problem can become serious and may lead to loss of leg. Consult a vascular or cardio vascular surgeon in time.

Ignoring can be dangerous

Statistics show that in India, the average rate of leg amputation per year among all diabetic patients is 10 percent, that is, out of 100 diabetic patients, 10 lose their leg every year. Whereas in diabetic patients above 65 years of age, this average is about five percent every year. You might not know that the risk of foot amputation in diabetic patients is almost one and a half times higher than that of people without diabetes. Long-running diabetes, uncontrolled amount of sugar in the blood, smoking, presence of albumin in the urine, loss of vision, tingling and numbness in the legs, reduced blood supply in the legs, etc., all these things can lead to diabetes. It becomes a direct and indirect cause of leg amputation in a patient. This shows that carelessness taken by a diabetic patient can be a direct cause of his becoming disabled.

Why does diabetes cause pain and tingling in feet?

Pain in the feet of a diabetic patient occurs due to many reasons. One reason is Neuropathy, which results in pain and tingling in the feet, especially in the soles and heels of the feet. Neuropathy in the muscles of the legs causes mild paralysis, which puts unnecessary pressure on the legs and bones. Along with this, the activity of joints also decreases. The combined effect of all these is that the complaint of pain and tingling in the feet always persists, and increases with walking.

Special conditions found in the feet of diabetic patients

The second biggest cause of pain in the legs is the decrease in the amount of pure blood going to the legs. Fat and calcium continuously accumulate inside the blood vessels that carry pure oxygenated blood to the legs and feet. As a result, there is a shrinkage in the blood vessels, which hinders the supply of pure blood. Due to carelessness in the initial days, this blood vessel gets completely blocked, in this condition the diabetic patient starts having unbearable pain in his legs. If a vascular or cardio vascular surgeon is not consulted on the spot, it may ultimately lead to leg amputation.

Another important reason is the reduced blood supply to the skin of the feet. This is called Autonomic Sympathetic Neuropathy (ASN) in medical language, due to which the pure blood is not able to reach its destination located in the skin of the leg, because the blood gets short circuited, in the same way. Just as a traveler, without reaching the designated destination, starts turning back midway.

Don’t be confused by the pink color of the feet

Often people and physicians get confused by the pink color of the skin of the feet of diabetic patients and hastily conclude that the blood flow in the feet is normal and adequate. This notion is false. If you want to know whether the supply of pure blood in the legs is sufficient or not, then you can do a simple experiment yourself. Lie down and keep your feet two feet above the chest for one minute. If the color of the feet changes from pink to yellow, then understand that the supply of pure blood in the feet is less. Be careful knowing that you are very close to getting wounds in your feet. Contact a vascular surgeon immediately.

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Why are feet more at risk in diabetes?

Due to autonomic neuropathy occurring in diabetes, the glands that produce sweat and lubricate the skin stop working properly, as a result of which the skin of the feet becomes very dry and the skin develops cracks. And pits are formed which become the reason for early infection in the feet. This is the reason why wounds form quickly in diabetic patients, and the infection reaches deep inside, which becomes very difficult to control. Sometimes this requires operation.

Don’t let bunions form on your feet.

Neuropathy not only causes pain in the feet, but due to carelessness, the possibility of bunions forming in the feet increases. Due to weakening of muscles, pressure on the bones of the leg increases. Due to this continuous pressure, bunions are formed at pressure spots in the skin. Due to bunions, a diabetic patient feels as if there is a pebble, stone or small stone inside the shoe. Due to this bunion, the pain in the feet becomes unbearable.

Where should diabetic patients go if they have foot pain?

If you are suffering from diabetes and feel pain in your legs while walking or complain of tingling sensation while lying in bed at night, then immediately consult a vascular or cardio vascular surgeon. It is very important to know the cause of pain. Often people mistake this type of pain for arthritis or sciatica and consult an orthopedic specialist. Sometimes, along with pain in the legs, there is also pain in the waist. When such a situation arises, do not be careless at all, because it means that the amount of pure blood going to the legs has reduced drastically.

Do not avoid important tests

To know the exact cause of foot pain in a diabetic patient, some important tests are necessary. Along with some blood tests, it is also necessary to check the blood supply. For this an investigation called Doppler study is required. In this test, it can be roughly found out where the supply of pure blood is being disrupted. It is on the basis of this investigation that a decision has to be taken regarding the necessity of angiography. Angiography reveals how much and where there is blockage in the blood vessels. Nowadays the technique of angiography has also changed, in this the patient does not need to be admitted to the hospital nor is there any need to put injection or tube in the thigh. This angiography is called 64-slice CT angiography. It takes only five minutes. Therefore, always go to a hospital where all these tests are available. On the basis of the angiography report, the direction of further treatment is decided.

Ways to prevent foot pain in diabetes

If you are a diabetic patient then first of all control the amount of sugar in your blood. Uncontrolled glucose levels in the blood are a clear sign of losing a leg in the future. It is very important for a diabetic patient to walk 5-6 kilometers daily. By taking daily walks, the supply of pure blood to the legs continues uninterrupted and secondly, the effect of Neuropathy on the legs is also reduced. Diabetic patients should protect the skin of their legs and feet from dryness and dryness because dry skin increases the possibility of skin cracking, which provides a way for germs to reach directly inside the feet. To reduce dryness of the skin, you can apply olive oil on the skin, but keep in mind that do not apply any oil or ointment between the toes. Do not allow corns and bunions to develop on your feet. For this, it is necessary that the shoes should be soft and of the right size and must be worn by inserting silicone pads of the right size inside the shoes. These insoles, which are called ‘diabetic insoles’, have proven to be very effective in protecting the feet. Special types of shoes are also available for diabetic patients, which should be worn only on the advice of a vascular surgeon.

Diabetic patients should never walk barefoot inside or outside the house, and should never wear shoes without socks. Keep feet clean and moisture free. Diabetic patients should always get their legs and feet checked by a vascular or cardiovascular surgeon every four months. If blisters or red rashes are seen anywhere on the feet, then immediately consult a vascular surgeon without any carelessness.

Treatment methods for leg pain

If it is found through examination that there is a blockage in the tube that supplies pure blood to the legs, due to which the blood supply to the legs is low, then effective steps have to be taken immediately to increase the blood supply to the legs. For this, bypass surgery of legs has proved to be very successful. In this special surgery, veins from the same leg or the other leg are used. Sometimes artificial blood vessels imported from abroad also have to be used in bypass surgery when the condition of the veins is not found suitable. Sometimes, in some special circumstances, one has to resort to angioplasty, but angioplasty and stenting done below the thigh is not very successful because its results look tempting in the initial days, but the benefits obtained from it do not last long. Is. Therefore, the method of treatment has to be decided very thoughtfully. Always go to a hospital where an experienced vascular surgeon is available and leg bypass surgery is done regularly. All these treatments fail if the diabetic patient has not completely stopped smoking and tobacco consumption.

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