Diabetic patients often think some of their symptoms are permanent. Many have this notion that they have to live with complications. Individuals with diabetes could have damage nerve fibers because of high blood glucose, which could change the metabolism of nerve cells. As a result, this could cause reduced blood flow to the nerve.

Board certified DPM Dr. Noel Silan from the Guam Foot Clinic says this complication is called diabetic neuropathy. The blood supply going through the nerves may not be functioning properly. As a result, patients lose the ability to feel pain. That's when ulcers form.

Said Silan, "Because of the lack of blood supply to the nerves, the patients then get numbness. They get tingling at the bottom of their feet and also get other symptoms from diabetic neuropathy (i.e., cramping, tingling, burning sensations, loss of balance, fatigue). Basically the patients just tell me their legs feel heavy sometimes."

Dr. Silan says most of the patients who walk into his clinic have diabetes. In fact, he sees approximately ten to 15 diabetic patients per day and around 50 people per month. Most of them suffer from diabetic neuropathy. He says the biggest misconception his patients assume they have to live with the symptoms but in reality, it could be reversed. He said, "A lot of these patients, if you put them on the right program, and give them the right medicine and eat certain vitamins, tell them which foods to avoid, a lot of times, their diabetic neuropathy symptoms can't not only stop progressing, but it can also be reversed."

If patients avoid treatment, they could get their feet infected resulting in amputations. Dr. Silan said if treated, the normal feeling in your feet would come back. "Unfortunately, what happens here on Guam is doctors get very busy and they forget there are specialists out there. So usually when I see these diabetic patients, I see them at the end. Meaning, I see them when they have a sore and they need an amputation when all of this could've been prevented to begin with. By how? Not referring the patient when they have a sore but basically referring patients once they tell you, 'Oh doctor, I have numbness or tingling in my feet.' That's when the doctor should say 'Well you know, there's a way to stop the progression of that,'" he said.

For more information on diabetic neuropathy or any foot conditions, contact Dr. Silan at the Guam Foot Clinic at 647-2925.