August 15, 2004
Question from Zambia:
An uncle of mine had a wound on his feet which later got infected. The treatment was done and the wound healed. The wound was on the bottom of his foot, but it has left a "hump" on his feet. The shoes he wears can be very uncomfortable. Are there any special people who can design special shoes for him, someone who also has experience in the diabetic field? I am looking for someone in Africa or the United Kingdom. Does type 1 diabetes eventually cause blindness? My uncle had successful laser treatment in one eye and an unsuccessful treatment in the other. What can be done to prevent further damage to his eyes, or is it impossible? He has had diabetes for 24 years. Can you send me more information on kidney problems associated with the disease and all other problems associated with the disease? Or, are there some books I can buy?
First, there is a specialty called podiatry that provides expertise in the evaluation and treatment of foot disorders that come with systemic diseases like diabetes. These healthcare professionals are responsible for prescribing inserts into shoes that will unload the pressure off that irregular area so that it will not end up be ulcerated again. Where you get the expertise is another question. I would recommend inquiring with local medical societies or hospitals to see if podiatrists or orthopedic surgeons with this level of expertise are available to you. We have many podiatrists in the United States. They have been invaluable to our patients with diabetes.
As for the question about diabetic retinopathy, laser treatments have been very effective in preventing blindness. However, it does not always work in people with longstanding disease. Additional measures may be required, but depend on the specific problem within the eye. You need the expertise of a retina specialist to review potential therapies. From a medical standpoint, it is important that blood pressure and glucose control are optimized. You can find additional references for diabetes and related complications through our web site and others. Publications can usually be ordered from these sites with information directed at patients and their families.