The importance of good diabetic foot care

Patient

Q: Dear Doctor, I am Indian,67yers,under Insulin injection. I have some problem in my foot. I have diabetic neuropathy and when I walk for long time as morning walk, I am experiencing burning and tender sensation in certain areas under my foot (in places where pressure points are supposed to be present).I am worried whether this would turn in to boils in due course. will you please advice me how to offload the pressure points by curtomised shoes, what medication should I use preferably antibiotic creams, anti-burn creams etc to prevent pressure point area problems turning in to boils etc.

Doctor

A:   Burning pains in the feet suggest neuropathic pain, or pain resulting from poor sensory supply in this area. In diabetes the nerves damaged are typically in a “glove and stocking” distribution, affecting the extremities. The danger of poor sensation in the feet is that you cannot feel when you step on a foreign body, like a splinter, or when you develop a callous from an ill-fitting shoe. Therefore you are at risk for developing ulcers and infections of the feet and legs. I would advise urgent referral to a podiatrist and a chiropodist, with regular follow-up, to assess the nerve supply in your feet and prevent complications arising from poor foot care.

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