by Mark A. Green, DPM
So which doctor do you see when your blood glucose is out of control? If you answered your PCP or endocrinologist, you are correct. But adding your podiatrist to the equation may be just what the doctor ordered. A podiatrist to treat your blood glucose? Zoinks! Ok, before you toss this in the He-Must-Be-a-Quack basket, indulge me for a moment.
Here is a scenario that I see quite frequently in my practice; “Doctor, I’m overweight, my blood sugar is out of whack, and I can’t exercise because my feet are killing me!”
After a thorough exam, we discuss the cause of my patient’s heel pain. I explain that while the excess weight may contribute to her pain, the overall instability of her feet, which is hereditary, is the actual cause of the pain. She’s instructed regarding stretching exercises, a prescription for anti-inflammatory medication is written, and impressions of her feet are taken for custom-molded orthotics to support her flattening arch. A month later, her pain is almost gone and she’s able to start exercising again.
So that’s where the podiatrist enters the equation. If I can relieve your foot pain (A), then you’ll be able to exercise (B). Regular exercise will improve your fitness and you’ll lose weight (C). Losing weight improves your body’s ability to regulate blood glucose (D). So by the algebraic Transitive Property (a term I once knew in the eight grade, but recently Googled), if A=B and B=C and C=D, then A=D and your podiatrist can help control your diabetes.
We know that a major factor in the onset of Type-2 diabetes is obesity and inactivity. Being overweight decreases your body’s ability to properly control blood sugar, increasing the likelihood of developing diabetes, and making it more difficult to maintain proper glucose levels once you have the condition. According to The Obesity Society, almost 90% of people with type-2 diabetes are overweight.
The good news is that studies have shown that walking or doing other aerobic exercise for 38 minutes daily, can improve your hemoglobin A1C by 0.4%. Additionally, walking almost 90 minutes per day has been shown to reduce the dosage of insulin needed by an average of 11 units per day and has actually shown that insulin therapy can be eliminated in 25% of these walkers. This level of exercise has been shown to decrease hemoglobin A1C levels by as much as 1.1%, reducing your risk of heart disease, and improving your cholesterol and triglyceride levels. But if your feet hurt or other foot problems arise, your ability and even desire to exercise is gone.
As an integral member of the diabetic health care team, your podiatrist will help resolve foot issues before they develop into more serious complications and, with regular examinations, help prevent problems from developing in the first place. So, back to my math analogy; by extrapolating the benefits of comfortable, healthy feet, your podiatrist just might be the variable that helps solve the equation for a healthier lifestyle, even in the presence of diabetes.