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Tuesday, July 5, 2011
I have Type II diabetes and I`m experiencing foot pain, especially in my toe area. I check my feet daily for sores or bruises and there are none found. Could this be a circulation problem? I see my doctor regularly but should I make a special appt. to be seen for this?
The overwhelming message we want to convey to people with diabetes is to be vigilant - extremely careful - about your feet and pay attention to any clues. With that in mind, I would say you should go ahead and see your doctor. However, let's review some factors that would help to distinguish how urgent this problem is.
We mostly want to be vigilant to catch infections early. It is fairly easy to tell that you have an infection if you have an open sore that is draining yellow thick fluid that represents pus. What about signs short of that? Signs of inflammation may represent an infection but they could also represent arthritis or tendonitis - signs of inflammation include redness, tenderness, warmth, swelling. If there is inflammation in the foot or ankle or leg and you can't tell whether there is an infection, then it is prudent to err on the side of caution and seek medical attention to rule out infection. Another common cause of inflammation in a foot in a person with diabetes may be an attack of gout - this represents inflammation in a joint due to deposition of uric acid crystals. Pain in the foot not related to inflammation can also result from diabetic nerve damage - so-called diabetic peripheral neuropathy. This is a common source of pain or numbness or tingling. If you experience pain that is not in a joint that gets worse with walking, that could potentially be a sign of inadequate blood flow to the tissues.
Bottom line: if you're not sure, then check.
Robert M. Cohen, MD
Division of Endocrinology and Metabolism
Department of Internal Medicine
College of Medicine
University of Cincinnati