December 2005 /January 2006

Diabetes -The Medical Perspective

Foot ulcers are sores on the foot.  They are more common in people who have diabetes.  Having diabetes and not keeping blood glucose in control increases the risk of getting a foot ulcer.  Other risk factors for foot ulcers include

Those who have diabetes should have an annual foot examination that includes assessment of skin for breaks or dryness; examination of toenails and possibility of foot deformity; adequacy of blood flow in the foot; and sensation detection in the foot.

To test sensation, the doctor will usually use a very thin wire the size of plastic fishing line called a monofilament. The doctor will stick the monofilament into the bottom of the foot in four to nine spots.  It is not a sharp wire and the pressure is not enough to penetrate the skin and bleed.  However, a person with good sensation will be able to feel all of the sticks.  As neuropathy develops, a person won’t be able to feel the sticks at one or more sites. 

Other ways to test for sensation in the feet include using a tuning fork or a small vibrating device.  Whatever instruments are used, the person with diabetes should receive an exam each year and know their risk level for developing foot ulcers.

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