Diabetes: Take Care from Head to Toe

Most of us could use a head-to-toe checkup now and then. But for people with type 1 and type 2 diabetes, it is important to get a head and toe checkup every year.

Nearly 21 million people in this country have diabetes, according to the latest statistics from the American Diabetes Association (ADA). For them, eyes and feet can be potential trouble spots.

The ADA recommends an eye exam and a foot exam by a medical professional each year. Diabetes can cause eye problems that could lead to blindness if left untreated. And when diabetes causes poor circulation and nerve problems in the feet, sufferers can develop wounds that are difficult to heal.

Eye to eye

Diabetes is the leading cause of new cases of blindness among adults ages 20 to 74. The ADA recommends that people with type 1 diabetes have a dilated and comprehensive eye examination by an ophthalmologist or optometrist within five years of diagnosis of diabetes. People with type 2 diabetes should have this exam shortly after their diagnosis.

Loss of vision can result from a condition known as diabetic retinopathy, in which the delicate blood vessels in the back of the eye swell and bleed. According to the National Diabetes Information Clearinghouse (NDIC), diabetic retinopathy causes 12,000 to 24,000 new cases of blindness each year.

"There may be substantial damage before a person is aware of visual problems,'' says Jeffrey L. Susman, M.D., a family medicine specialist in Cincinnati. "So it is important to have regular eye exams whether you are having problems or not.''

During the eye exam, an ophthalmologist can look into each eye and check along the inner back wall for damage. "It is something that, if we can catch it early on, we can do a great deal to help,'' Dr. Susman says.

On your feet

The ADA says the risk of ulcers or amputations increases in people who have had diabetes more than 10 years. The risk also increases for men, for people who don't have good control of their blood sugar, and for those with cardiovascular, eye, or kidney complications. According to the NDIC, about 54,000 lower-limb amputations are done each year on people with diabetes.

Diabetes can decrease blood flow and damage nerves in the arms and legs. Common scrapes and bumps of everyday life can end up causing serious problems such as tissue death and gangrene. The decrease in blood flow also affects the healing process. This can lead to infection and, in the worst cases, amputation.

"Our feet are subjected to a tremendous amount of pressure and wear,'' says Dr. Susman. "Foot care should be practiced each day in addition to being part of an annual checkup."

Follow these healthy "footsteps":

• Check daily for calluses, cuts, or cracks in the skin and look for signs of infection.

• Use a mirror, if necessary, to look at the bottoms of your feet.

• Keep feet clean. Do not use alcohol or hydrogen peroxide. They dry out skin.

• Be careful when soaking feet in hot water. Nerve damage decreases sensitivity to temperature. You could burn yourself.

• Do not go barefoot indoors or outdoors. Indoors, wear slippers or sandals if you don't want to wear shoes.

• Make sure all footwear fits properly.

• Do not cut calluses yourself. See your doctor or podiatrist, who also can check for ingrown toenails and other potential problems.