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Neuropathy & pains

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R

Rossana

New Member
Relationship to Diabetes
Type 1
I have had diabetes 1 for 6 years and is still uncontrolled. I fractured my foot a year ago and is still recovering but since then I have been getting sharp stabbing pains in my feet and legs, which is odd as it is in both feet.
As I said the injured foot has not recovered and I cannot put it flat, 3 of my toes I cant bend properly. I dont know if the diabetes is causing more problems.
Grateful for any advice. Thanks
 
Hi @Rossana and welcome to the forum. I see you are based in Spain where the medical system is different to what we are used to in the UK. That is not a problem and I only mention it so that our members, who are mostly based in the UK, are aware of it and can frame their responses to take it into account.
 
Hi Rossana and welcome from me too.

Sorry to hear about your foot. Was there an accident or some trauma to cause the fracture. I believe with Charcot it can just collapse but @Flower is our resident expert on it, so she may be able to give you some advice or reassurance.

As regards your diabetes, you say it is uncontrolled after being diagnosed 6 years.... Presumably you are on insulin?? Can you tell us what problems you are having with managing your BG levels. Are you on a Basal/Bolus Multiple Daily Injection (MDI) insulin regime and if so, which insulins or perhaps you have an insulin pump? Just wondering if we can help you with some tips to improve your diabetes management which might then aid the healing of your foot. High BG levels leave you at risk of infection setting in as you are probably well aware as well as neuropathy so getting things under control for that alone is really important.
Do you know your most recent HbA1c so that we can understand where you are at with your diabetes? Don't worry about it being high, it just gives us an idea of how much help you might need to get things under control so we can suggest appropriate strategies.
 
Hello @Rossana and welcome

I'm sorry to hear the ongoing problems you're having with your foot. What treatment did you have for the fracture when it happened & are you still attending a clinic - orthopaedic/podiatry if the foot hasn't healed? What have they advised you to do - if anything- about ongoing treatment & protection of your foot in a cast or moon boot?

It certainly sounds like it has elements that could point to Charcot foot although it needs to be ruled in/out rather than assuming it is. Charcot is a relatively rare complication and can be overlooked as a diagnosis and mistaken for a sprain, infection or gout because it causes similar issues -swelling, redness and pain -although the pain is often diminished due to nerve damage. From my experience Charcot does take multiple months/years to settle and can unfortunately result in foot shape deformities such as a foot that doesn't have proper contact with the floor due to collapsed bones plus multiple other fractures and issues such as bent/dislocated toes. It can as I know from personal experience happen in both feet. Please ask for an urgent appointment and assessment of your feet - I hope things settle but you need to know what you're dealing with and if it is Charcot foot time is of the essence to give you the best chance of stopping further damage.

This advice is from the Diabetes UK site - https://www.diabetes.org.uk/guide-to-diabetes/complications/feet/charcot-foot

Are you getting help and support to get better control of your blood sugar? Stable -or as stable as you can get- blood sugar is a lot kinder on damaged nerves and limits/slows complication progression. Wishing you well.
 
rebrascora said:
Hi Rossana and welcome from me too.

Sorry to hear about your foot. Was there an accident or some trauma to cause the fracture. I believe with Charcot it can just collapse but @Flower is our resident expert on it, so she may be able to give you some advice or reassurance.

As regards your diabetes, you say it is uncontrolled after being diagnosed 6 years.... Presumably you are on insulin?? Can you tell us what problems you are having with managing your BG levels. Are you on a Basal/Bolus Multiple Daily Injection (MDI) insulin regime and if so, which insulins or perhaps you have an insulin pump? Just wondering if we can help you with some tips to improve your diabetes management which might then aid the healing of your foot. High BG levels leave you at risk of infection setting in as you are probably well aware as well as neuropathy so getting things under control for that alone is really important.
Do you know your most recent HbA1c so that we can understand where you are at with your diabetes? Don't worry about it being high, it just gives us an idea of how much help you might need to get things under control so we can suggest appropriate strategies.
Click to expand...
Hi thanks for your response.
Yes I fell over thought it was just a sprain but turned out to be two fractures between big toe and next one.
I am on insulin Lantus and before was Apidra but changed it to Tresiba.
I think my main problem is I cannot work out my carbs properly. I either inject too much or too little.
I am also not a good eater partly because I dont have a good appetite and also because I drink too much!
I dont know what my HbA1c level is
Any advice would be helpful.
Thanks
 
Flower said:
Hello @Rossana and welcome

I'm sorry to hear the ongoing problems you're having with your foot. What treatment did you have for the fracture when it happened & are you still attending a clinic - orthopaedic/podiatry if the foot hasn't healed? What have they advised you to do - if anything- about ongoing treatment & protection of your foot in a cast or moon boot?

It certainly sounds like it has elements that could point to Charcot foot although it needs to be ruled in/out rather than assuming it is. Charcot is a relatively rare complication and can be overlooked as a diagnosis and mistaken for a sprain, infection or gout because it causes similar issues -swelling, redness and pain -although the pain is often diminished due to nerve damage. From my experience Charcot does take multiple months/years to settle and can unfortunately result in foot shape deformities such as a foot that doesn't have proper contact with the floor due to collapsed bones plus multiple other fractures and issues such as bent/dislocated toes. It can as I know from personal experience happen in both feet. Please ask for an urgent appointment and assessment of your feet - I hope things settle but you need to know what you're dealing with and if it is Charcot foot time is of the essence to give you the best chance of stopping further damage.

This advice is from the Diabetes UK site - https://www.diabetes.org.uk/guide-to-diabetes/complications/feet/charcot-foot

Are you getting help and support to get better control of your blood sugar? Stable -or as stable as you can get- blood sugar is a lot kinder on damaged nerves and limits/slows complication progression. Wishing you well.
Click to expand...
Hi thanks for replying
It was due to a fall which I thought was just a sprain but turned out to be two fractures between big toe and next one. It took them 3 weeks to find out! Then I had a cast put on end of November 2019 then a boot and finally, due to covid, got physiotherapy in August which really helped and then that was it. Slowly it has got better but still cant properly bend the other 3 toes and my foot doesnt go flat. Also feels like theres a bump to one side on the bottom but cant see any difference really.
I am going to my GP tomorrow so will see what she says and who to refer me back to
thanks for your help
 
Thanks for that extra info.... can you just clarify that the insulins you are now using are Lantus and Tresiba because these are BOTH BASAL insulins. I could understand if they changed the Lantus to Tresiba but not swapping the Apidra for Tresiba.... or maybe I misunderstood.... or you got confused.
Can you explain how you use these insulins if I have understood you correctly, as this may be a big part of your problem in managing levels. Ie when you take each insulin and how much or which one with food?

Obviously you know that the alcohol affects things and isn't the best but we all have our own demons/weaknesses. I like a drink but having just overcome my almost life long sugar addiction I am not about to swap it for something else destructive so I am monitoring my intake and try to have at least one day a week without it, although just writing that makes me think I need to up it to 2 days a week!... It definitely looks bad written down publicly! 😱 Maybe set yourself little goals with reducing the drink to help you get better control of your diabetes and thereby help your foot to heal and improve your general health. I hope that doesn't sound too preachy!

I don't eat regularly either (this is the benefit of a basal/bolus insulin regime) so it is not necessary for good BG control but having the right insulins is very important, so if you can clarify that situation it would be helpful.
 
Hi

Yeah me getting confused!!
I take 16 Tresiba in the morning as I kept forgetting at night.
and take Apidra (what my machine tells me) before meals or if necessary if I find I am too high.
 
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