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December 26, 2002

Complications, Daily Care

Question from Smyrna, North Carolina, USA:

I have had type 1 diabetes for about eight years and have learned to live with it very well, but lately, it has been getting cold where I live, and I have had a big problem with keeping my feet warm. I can stand outside and my feet will go numb and it takes hours to warm them up. They turn white then when I try to warm them, blackish, then finally pink (normal like color). I am very concerned and along with this, my blood sugars have been skyrocketing. I am eating at my normal times and having to take more insulin, but my schedule hasn't really changed. Have you got any advice for me about my blood sugars or more importantly my feet? I am very scared I will lose a toe if this keeps happening.

Answer:

First, I would make sure you have your feet examined by a physician who has the knowledge to spot problems with circulation or impending breakdown of the skin. You should also learn how to examine your feet for any problems so that you can prevent any problems that arise. In addition, good blood sugar control can minimize the pins and needles sensation that occurs. I would also suggest not to put your feet in the situation where they are exposed to extreme cold. When neuropathy develops, the skin does not regulate its temperature appropriately. Make sure to wear plenty of protection and observe them often. I would also make sure the high sugars are not the result of some impending infection or other problem that needs additional medical attention.

JTL