Numbness can come from a range of difference sources not the least of which is diabetes which affects around 1 million people in Australia.
There is still some conjecture in the world of science as to the exact physiological cause and development process of the numbness that develops in diabetic feet. This is largely because it’s development is complex and multifactorial. There are fortunately however, some definite associations that reveal the main factors involved – and the good news is these are largely modifiable and the numbness therefore largely preventable!
In short, when diabetics have too much unutilised sugar in their blood stream the nerve signals get disrupted somewhere between the brain and the source of the signal.
The problem starts when, through varied lifestyle and/or hereditary factors the body begins to lose its ability to produce or utilise insulin. Insulin is the chemical in the body that allows the food that we eat (which gets broken down into sugars) to cross cell membranes and then be utilised by those cells within body tissues. So, what’s the big deal with too much sugar in the blood? If its not being used why can’t it just stay there until the body can use it? Well… primarily this becomes a problem for those few body tissues which don’t require insulin to consume the sugars. This is because there is obviously now an excess of sugar available for those tissues. These tissues are the retina of the eyes, the kidneys and… you may have guessed it – the nerves. This then becomes an “unrestrained child in a candy store” situation. With so much availability the retina, kidney and nerves absorb excessive amounts of blood sugars just as a child which has too much candy available to them and no control.
From that point on it becomes a little vague as to the precise biological process of the problem. It is believed that, at least in part, this excess sugar absorption of nerve tissues increases certain waste products that form within the cells (otherwise known as free radicals). These free radicals are usually processed and removed easily but in this situation an overload develops. Overtime, this overload stress clutters the nerves and impairs their connection with the brain. Signals are interfered with and eventually fail to reach their destination – the brain. The person with diabetes at this point will begin experiencing abnormal sensations such as numbness, tingling, burning or even pain, particularly in the feet and lower limbs as the nerves continue misfiring. This is known as peripheral neuropathy.
This has obvious implications for the patient as these abnormal sensations can reduce a person’s ability to sleep or function normally through the day. In addition to these irritating complications and perhaps even more importantly is the potential for a person to sustain injuries to their feet or legs and not even be aware of it. Imagine you tread on something sharp and don’t realise, the area becomes inflamed and infected and you just keep stepping on the same spot because you don’t notice the pain. If the problem remains unattended it can become quite serious quite quickly. This is why it’s so important to take good care of your feet as a diabetic.
It is for this reason that people with diabetes are strongly advised to visit a podiatrist when they are first diagnosed with diabetes and then at least once a year for assessment and in order to prevent these complications and at the very least manage them if they are already occurring.
Your podiatrist will assess each of the different types of nerves in your lower limbs, provide you with your current nerve health status with thorough explanations and provide you with strategies on how to prevent them from deteriorating. This will include reducing pressure areas that predispose to further injury, guidance on most appropriate footwear, exercises that will strengthen the effectiveness of your nerves and specific strategies you can use that will protect your feet from injury. If you have any of the above mentioned abnormal sensations in your feet or legs or have been diagnosed with diabetes and have not been assessed this year get along to your podiatrist as soon as possible.
It is worth noting that these nerve problems are only the start of the complications that can come with diabetes. Your blood flow can also be affected and this is much more insidious and can develop unnoticed by the person. Your podiatrist is trained to find and manage these complications as well.
Our team at Riverside Podiatry take pride in their specialised experience in preventing and managing these kinds of problems with thorough and gentle.