Management of Diabetic Foot Problems?
Management of any complication of an illness must initially involve the management of the illness itself. This prevents progressive damage while affording the opportunity to address the complications. In diabetes, this requires reigning in the hyperglycemia that is toxic to blood vessels.
Management of the diabetic illness itself is the crucial linchpin in management of complications from diabetes, such as diabetic foot pain. A simple blood test, the hemoglobin A1c, is done every three months as an important tool for doctors to follow their patients and ensure good diabetic control. Once the diabetes is under control, the healthcare professional is best equipped to treat its complications.
Secondarily, but important also, is evaluating for and managing other risk factors such as hypertension, triglyceride control, smoking, etc.
Treatment of Diabetic Foot Pain
Because of the sensory deficiencies in the nerves, not all diabetics develop foot pain. However, if it occurs, its management is via three approaches:
- Glycemic control: This means that since diabetic foot pain or neuropathy is caused by poor control of diabetes (higher sugar in the blood than what is optimal), then controlling sugars better will help lessen the problem and—more importantly—prevent further damage.
- Foot care: The feet should be inspected daily for any dry or cracking skin, splits, or infections. Foot care also includes frequent re-checks by one’s doctor who can pick up on warning signals or follow any problems over time.
- Pain management: Only a few people with diabetes have severe, debilitating pain, but of those who do, pain can be approached via a step-wise protocol of antidepressants, anticonvulsants, anti-inflammatories, and topical anesthetics, and if necessary, a combination that may or may not include opioids. The best management of the pain, however, is to prevent it from ever occurring by way of frequent doctor visits.