Foot Reference

Foot care

People with diabetes need to take special care of their feet. Neuropathy and blood vessel disease both increase the risk of foot ulcers. The nerves to the feet are the longest in the body, and are most often affected by neuropathy. Because of the loss of sensation caused by neuropathy, sores or injuries to the feet may not be noticed and may become ulcerated.

At least 15 percent of all people with diabetes eventually have a foot ulcer, and 6 out of every 1,000 people with diabetes have an amputation. However, doctors estimate that nearly three quarters of all amputations caused by neuropathy and poor circulation could be prevented with careful foot care.

To prevent foot problems from developing, people with diabetes should follow these rules for foot care:

Experimental treatments

Several new drugs under study may eventually prevent or reverse diabetic neuropathy. However, extensive testing is required by the U.S. Food and Drug Administration to establish the safety and efficacy of drugs before they are approved for widespread use.

Researchers are exploring treatment with a compound called myoinositol. Early findings have shown that nerves in diabetic animals and humans have less than normal amounts of this substance. Myoinositol supplements increase the levels of this substance in tissues of diabetic animals, but research is still needed to show any concrete lasting benefits from this treatment.

Another area of research concerns the drug aminoguanidine. In animals, this drug blocks cross-linking of proteins that occurs more quickly than normal in tissues exposed to high levels of glucose. Early clinical tests are under way to determine the effects of aminoguanidine in humans.

One approach that appeared promising involved the use of aldose reductase inhibitors (ARIs). ARIs are a class of drugs that block the formation of the sugar alcohol sorbitol, which is thought to damage nerves. Scientists hoped these drugs would prevent and might even repair nerve damage. But so far, clinical trials have shown that these drugs have major side effects and, consequently, they are not available for clinical use.

General hints

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