Dr. Harry Papagianis (NorthShore) - 8:56 AM:
Good morning,
Thank you for joining me on this mornings chat "Living with Diabetes: The Importance of Foot Health." My name is Harry Papagianis, DPM. I am a licensed Podiatrist and I will be answering your questions. Please understand that I will not be able to confirm a diagnoses or treat any troubles you may have over the computer. If you would like to further discuss in detail any questions you may still have after the online chat, feel free to call my office at (847) 498-4998.
Thank you,
Dr. Harry Papagianis, DPM
Brenna (Moderator) - 9:14 AM:
Thank you for joining us today. Our chat will begin at 10 a.m. but you can submit questions now and at any point during the chat.
Angela (Chicago, Illinois) - 9:57 AM:
will you please discuss the effects of Peripheral Neuropathy, I have had it for 4 plus years. I don't want to lose my feet. my toenails look dried out, and a grayish tone. should I worry????
Dr. Harry Papagianis (NorthShore)
Peripheral neuropathy can come in different forms. Painful for some and numbness for others. When the neuropathy is a form of numbness the biggest thing to worry about is having something stuck in the bottom of your foot without knowing it. Another complication is constant friction from shoes that do not fit properly breaking down the skin. You should do daily checks to make sure you don't have any sores on your feet. If you notice and red marks or open sores, check with your doctor. The dried nails may be a fungus infection.
DENISE (ORLAND PARK ILLINOIS) - 10:03 AM:
I have been having severe pain in my toes. I am a type 2 diabetic. Should I see a doctor?
Dr. Harry Papagianis (NorthShore)
Absolutely. The pain can be something as simple as arthritis but without a physical and check up you can not know for sure. You want to make sure that the doctor checks your blood flow to your feet as well as checking how well the nerves in your feet are working.
Anonymous - 10:06 AM:
does diabetes delay the healing process after surgery?
Dr. Harry Papagianis (NorthShore)
For some people with diabetes the healing process my be delayed. It depends on the severity of the disease as well as how well the patient has been maintaining blood sugar levels. If you are thinking about having surgery make sure you ask your doctor about the healing process and discuss the pros and cons of the procedure especially if the surgery is not an emergency.
David (Evanston, IL) - 10:12 AM:
There are these dark purple spots around my ankles and lower legs. It was getting worse and went to check them out and my diagnosis was type 2 diabetes. The doctor told me they would disappear once glucose was controlled. Can you explain to my what this may be and how gluose is related? Any way to expediate or treat this?
Dr. Harry Papagianis (NorthShore)
Really hard to say without seeing the spots. There is something called diabetic dermopathy. If this is what you have it is true that when your sugar is under control the spots will go away leaving a scar behind. The best way to resolve the problem as quickly as possible is to maintain a healthy blood sugar level.
JUDI (BRAIDWOOD, IL) - 10:18 AM:
I am experiencing either very hot or very cold toes. They will also turn blue if really cold at times. I also have a feeling like I'm walking on rocks on the balls of my feet. No numbness or tingling at all. I presume this is due to neuropathy? Wondering if other than controlling my BG levels is there anything else i can do to prevent this from getting worse. I am 65, overweight and diabetic for 7 years. THANKS FOR YOUR HELP!
Dr. Harry Papagianis (NorthShore)
Start with following up with your doctor. Have them check your circulation and the nerves in your feet. The change in colors you are describing in your toes may be something called Raynoud's syndrome. Neuropathy can also play a part in the symptoms you are describing as well. Get your BG under control to slow the progress and also check with NorthShore for diet counseling and weight management.
Melissa (Chicago, IL) - 10:24 AM:
Good morning Dr. Papagianis, Do you have any recommendations for keeping the skin on the feet moisturized and prevent skin cracking. Also what is the most important piece of advice you would give a diabetic regarding foot care?
Dr. Harry Papagianis (NorthShore)
Use lotion. A lot! Typically the more expensive lotions do not work any better. Get something on sale and use it two to three times a day. If you are still having problems with cracks, use a heavy lotion at night and cover with a sock. As far as a important piece of advise, make sure you keep your glucose under control. When your blood sugar is on a roller coster ride it plays havoc with your nerves and circulation.
Brenna (Moderator) - 10:28 AM:
Thank you everyone for your questions. This has been a popular topic this morning. We will attempt to get through every question but must apologize in advance if we are unable to address all questions in this one hour time period.
Max (Naperville) - 10:31 AM:
How often shoudl you have your feet checked by a doctor? What signs should you look out for that there might be a problem?
Dr. Harry Papagianis (NorthShore)
If you do not suspect any problems and you are otherwise healthy, every six months is fine. The more severe someones diabetic symptoms are the more they should be seen, sometimes once a month. The big things you should watch for is numbness or coldness in the feet. This could be signs of neuropathy or poor circulation. Also, if you ever notice something different with your feet (change in skin color or shape) go see your doctor right away.
emily (Chi) - 10:37 AM:
45 and I've only been recently diagnosed with type 2 diabetes. What can I do to ensure that I have minimal problems with my feet while I deal with diabetes.
Dr. Harry Papagianis (NorthShore)
The best way to ensure minimal problems is to maintain a healthy blood glucose level through diet, exercise, and medication provided by your doctor. Also, see with a Podiatrist to get a baseline on your feet health so a long term plan can be made for you.
Shawn - 10:41 AM:
What's involved in a diabetes foot exam? What are you looking for?
Dr. Harry Papagianis (NorthShore)
Basically with a diabetic foot exam the doctor is checking your circulation, nerve function, and looking for any abnormal skin changes.
Anonymous - 10:43 AM:
Is prediabetic patient likely to develop foot ailments like a diabetic?
Dr. Harry Papagianis (NorthShore)
Difficult to say. Not all diabetics go on to develop problems with their feet. I have many diabetics that I see in practice that have zero problems after being diagnosed with diabetes years ago. Just maintain a healthy lifestyle and get regular check ups to make sure you're on the right track.
Brenna (Moderator) - 10:44 AM:
There are 15 minutes left in this chat. Please submit your final questions.
Jake (Northbrook) - 10:48 AM:
If you have diabetes should you see your doctor for all injuries to your feet? Are there ways you can handle things yourself from home wihtout seeing a doctor?
Dr. Harry Papagianis (NorthShore)
I don't advise diabetics to self treat. It's always a good idea to see a doctor with an injury. Sometimes with diabetes, the person does not realize how bad the injury is or if there is a infection.
Nazy - 10:51 AM:
Are there things you should avoid to prevent problems with your feet if you have type 2 diabetes?
Dr. Harry Papagianis (NorthShore)
One thing to you should avoid is walking barefoot or in improperly fitting shoes. One of the possible complications of diabetes is numbness. Walking barefoot can lead to accidentally stepping on something without knowing it. Same goes for improperly fitting shoes. If the shoe is to tight or to loose it can cause to much friction and break down the skin.
Diane (Lakeview) - 10:56 AM:
If you develop a foot ulcer, what can you do to prevent the need for surgery?
Dr. Harry Papagianis (NorthShore)
First thing is have a doctor tell you why you developed the ulcer. Is it from pressure, poor arteriole circulation, or poor venous circulation. Once you know the cause, then you can discuss prevention options.
Brenna (Moderator) - 11:01 AM:
Thank you everyone for your participation today. And thank you Dr. Papagianis for your time this morning.
We apologize that we unable to get to every question. A transcript of the chat will be made available later today.
Dr. Harry Papagianis (NorthShore) - 11:05 AM:
Thank you for your questions. If you have a question you would like to ask or if you would like to further discuss a question that was asked please feel free to call my office at (847) 498-4998. If I am seeing patients, leave a message with the receptionist and I'll get back to as soon as possible.