toes throb and tingle

by bill
(scranton PA, united states)

I do have type 2 diabetes, my glucose readings range from 140 to 220.

I take glipiride (1mg) twice a day.
what I need to know is, are my feet this way because of diabetes or could it be possible I have tarsal tunnel syndrome in both feet?

Over the years ive had problems with my feet.I'm 51 years old and battled gout for six years. (1998 to 2004)
Found out in 2005 that I have type 2 diabetes. since I have been treated for diabetes I have not had a gout attack.
also I could stand to lose 20 lbs.

I need help bad. I am a construction electrician and am on my feet at least 8 hours a day. By the end of the day my feet and lower back are absolutely killing me. I can barely walk to my car.
I hate to say this but because of the economy I've been laid off much more than I work.
I need to get help now in case work picks up. I would appreciate your help very much.

RESPONSE
Hi Bill,

Unfortunately, I cannot really help you without actually examining you but there are a few things you should give consideration to.
First of all your blood sugars are too high. Each day that your sugars are elevated, is a day the disease does more damage to your body most of which is not reversible. When a diabetic controls his blood sugars properly, many of the symptoms from the disease start to diminish.
Since you apparently are an adult onset diabetic there is a very good chance that if you were to lose the necessary weight (probably more than 20lbs.) you would probably see your blood sugars better regulated. I see this all the time in my patient population.
The person to see for this is a nutritionist who specializes in diabetes. You need to re-learn your eating habits.
As far as your foot complaints go, there are two area of the foot that is affected in diabetes. One is a reduction in circulation to the feet and the second is loss of sensation or other neurological symptoms. The higher your blood sugars, the greater the symptoms.
Both poor circulation or diminished neurological function could cause some or all of your symptoms; it is impossible for me to tell which is your problem, obviously.
In general terms, diabetic neuropathy is a constant, it occurs regardless of what you are doing or the time of day. Circulation related problems can be activity dependent. Being off your feet with them elevated (eg: sleeping) can worsen arterial circulation; standing long hours can worsen you venous circulation (return of blood to the heart).
Now, the thing that jumped out at me in your description is that by the end of the day your feet and back are both "killing" you. This would suggest to me that the back may be part of the source of your foot pain, particularly what is referred to as a radiculopathy or irritation of the leg nerves as they come out of the spinal column. This type of condition could cause neurological distress in your feet.
Tarsal tunnel is also a possibility but again without being able to examine you, I have no real idea.
My advice to you is to seek the services of a good foot specialist in your area; start there. But be sure to mention your lower back issues as well so that can be ruled out and as I said earlier get your blood sugars under control by losing weight and working with your medical doctor. You will be amazed how much better you will feel.

Marc Mitnick DPM
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