Managing Numbness and Redness in Toes for Seniors with Diabetes

The toes are red and numb?

I am 83 years old and have hypertension and diabetes.
I take medication every day.
Since last year, I have been experiencing numbness in the toes of both feet, along with a reddish appearance.
I have tried soaking them in warm water, but there has been no significant improvement.
What should I do?

Ahua, 80~89 year old female. Ask Date: 2013/04/15

Dr. Cai Zonglin reply Internal Medicine

Diabetes complications include neuropathy, which can affect sensory nerves, motor nerves, and even autonomic nerves.
If there is redness and warmth in the feet, infection (such as cellulitis) must be ruled out before suspecting neuropathy.
Numbness and pain are associated with sensory nerve damage, and the redness and warmth should also be evaluated for possible autonomic neuropathy, such as Charcot foot.
The primary care focus is on controlling blood glucose levels and foot care to prevent wound infections and foot deformities.
Mild pain can be alleviated with medication, but if the pain worsens, a consultation with a pain specialist and orthopedic evaluation may be necessary.

Reply Date: 2013/04/15

More Info

Managing numbness and redness in the toes, especially for seniors with diabetes, requires a comprehensive approach that addresses both the symptoms and the underlying causes. Given your age, history of high blood pressure, and diabetes, it is crucial to take these symptoms seriously, as they could indicate complications related to your diabetes, such as peripheral neuropathy or poor circulation.

Understanding the Symptoms
1. Numbness: This sensation often arises from nerve damage, which is common in individuals with diabetes. High blood sugar levels can lead to diabetic neuropathy, where the nerves, particularly in the extremities, become damaged. This can result in numbness, tingling, or a burning sensation in the feet and toes.

2. Redness: The redness in your toes could be a sign of inflammation or poor circulation. Diabetes can affect blood flow, leading to conditions such as peripheral artery disease (PAD), where narrowed arteries reduce blood flow to the limbs.

Recommended Management Strategies
1. Regular Monitoring: Keep a close eye on your blood sugar levels. Maintaining them within the target range can help prevent further nerve damage and complications. Consult with your healthcare provider to adjust your medication if necessary.

2. Foot Care: Proper foot care is essential for diabetics. Inspect your feet daily for any cuts, blisters, or changes in color. Wash your feet daily with mild soap and warm water, and dry them thoroughly, especially between the toes. Moisturize your feet to prevent dryness, but avoid applying lotion between the toes to prevent fungal infections.

3. Warm Water Soaks: While you mentioned that soaking your feet in warm water did not provide significant relief, it is still a good practice. Ensure the water is not too hot, as diabetes can impair your ability to feel temperature changes. You might also consider adding Epsom salt to the soak, which can help reduce inflammation.

4. Footwear: Invest in well-fitting shoes that provide adequate support and cushioning. Avoid tight shoes that can restrict blood flow and exacerbate numbness and redness. Orthotic inserts may also help improve comfort.

5. Physical Activity: Engage in regular physical activity, as tolerated. Exercise can improve circulation and help manage blood sugar levels. Simple activities like walking or stretching can be beneficial. Always consult your doctor before starting any new exercise regimen.

6. Dietary Adjustments: A balanced diet that is low in sugar and refined carbohydrates can help manage blood sugar levels. Incorporate foods rich in omega-3 fatty acids, such as fish, nuts, and seeds, which can help reduce inflammation.

7. Medication Review: Discuss your current medications with your healthcare provider. Some medications can contribute to numbness or poor circulation. Your doctor may consider adjusting your treatment plan based on your symptoms.

8. Consult a Specialist: If the numbness and redness persist or worsen, it may be beneficial to consult a podiatrist or a neurologist. They can perform a thorough examination and may recommend additional tests, such as nerve conduction studies, to assess the extent of nerve damage.

9. Manage Blood Pressure: Since you also have high blood pressure, ensure that it is well-controlled. High blood pressure can exacerbate circulation issues, so regular monitoring and adherence to your prescribed medication are essential.

Conclusion
In summary, managing numbness and redness in your toes involves a multifaceted approach that includes monitoring blood sugar levels, practicing good foot care, wearing appropriate footwear, engaging in physical activity, and possibly adjusting medications. It is crucial to maintain regular communication with your healthcare provider to address these symptoms effectively and to prevent further complications. If you notice any new symptoms or if your current symptoms worsen, do not hesitate to seek medical attention promptly.

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