The Nerve of Your Feet!

Great diabetes care does not guarantee problem-free extremities.

Joy Pape By Joy Pape, RN, BSN, CDE, WOCN, CFCN

Spring has sprung. I hope you are managing your diabetes so you can continue to have a spring to your step.

If you have a question, someone else usually has the same question. That's why group education works so well. We learn from each other. This month let's continue to answer some questions that I'm sure will help others.

Cynthia wrote saying she has type 2 diabetes that she manages well. Her A1C is 5.5 and her blood glucose ranges from 70mg/dl to 150mg/dl, depending on when she checks and when she ate last.

Cynthia asks…
"My question is this, sometimes when I am standing or walking it feels like I am walking on cotton balls under the pads of my toes. They aren't painful, but it feels like there are cotton balls under them. When I lift up my foot and touch the toes without and shoes or socks on, it doesn't feel like that. Does this have anything to do with the nerves? I take 2.5mg of Glyburide in the morning and another 2.5 at night. That is all the meds I take for the diabetes."

My response:
Cynthia, thank you for asking, and, congratulations for taking such good care of you and your diabetes. As for your symptoms, you say you feel like you are walking on cotton balls under the pads of your toes. You wonder if this is related to your nerves. I can't diagnose your problem, but I can tell you that the best way to prevent nerve problems (neuropathy) is to get and keep your blood glucose, blood pressure, and your weight to as near normal as possible. It sounds like you are doing well with your blood glucose. Symptoms of nerve problems can be different for each person. Although you keep everything in check, it does not fully guarantee you won't have nerve problems, but it is your best insurance. There is a little more to this. Although you have good blood glucose numbers now, I don't know your history. Many people get nerve problems before they start managing their diabetes. My advice to you is to talk with your health care team to see what exactly is going on so you can take care of this too. When it comes to foot care, prevention is always your best treatment. Keep up the great work!

Madelyn wrote saying she noticed her baby toe was red and hurting. She doesn't remember hitting her toe, but this is the foot that had numbness for a while.

Madelyn asks…"Should I be concerned about it? The redness is leaving. It has a little redness, and it's not as sore as it was.

My response:
You should always be concerned about redness on your toes. It is good that it's leaving and not as sore as it was. You say this was the foot that had some numbness, therefore you could have hit it and not known it. Or, it could be that your shoes don't fit correctly. Many times a toe gets red from poor fitting shoes. It's always good to try to figure out why you think there is redness, relieve the cause, and see if it gets better. If it's not better within 24 hours, call your health care team. Although it is better now, I encourage you to visit your health care team, one of which is a podiatrist so together you can determine the cause of the redness to prevent the problem from getting worse. It is wise of you to ask.

See you all next month.

EnJOY the Spring and take care of your feet!

Read Joy's bio here.

Read more of Joy Pape's columns.

NOTE: The information is not intended to be a replacement or substitute for consultation with a qualified medical professional or for professional medical advice related to diabetes or another medical condition. Please contact your physician or medical professional with any questions and concerns about your medical condition.

Last Modified Date: July 08, 2013

All content on is created and reviewed in compliance with our editorial policy.

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by Brenda Bell
Many people say that depression is a side effect or complication of diabetes. Without discounting the association of the psychological condition with the physical one, I'm not convinced that our high and/or unstable glucose levels are directly responsible for that change in our mental state. My belief is that the unrelenting need for self-care, for following the sort of care schedules that can drive licensed, professional caregivers crazy, is what overwhelms us...
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