Juvenile Diabetes and Podiatric Concerns
By Kevin T. Naugle, DPM, MBA

Very often when a child is diagnosed with diabetes it becomes an entire family affair. The initial diagnosis can be very traumatic for everyone. This not only can be physical, but mental and emotional as well. Diabetes has a very high genetic or familial link to parents, often skipping generations. Statistically, diabetes appears in the Native-American, Hispanic, and African-American families at a much higher rate. Unfortunately, with juvenile diabetes it can “just happen.”

Podiatric concerns in the juvenile diabetic can be difficult to assess because often there are little or no symptoms. Usually, juvenile diabetes will present with lethargy and extreme glucose levels with little podiatric problems versus the adult onset diabetic. Adult onset diabetics may begin with complaints of pain, tingling, burning, or numbness. These complaints are often absent in the juvenile diabetic. Therefore, the importance of prevention and education in the juvenile diabetic is paramount.

The juvenile patient, and especially the parents, needs to become aware of the complications related to the disease. Complications include the eyes, kidneys, and the cardiovascular, digestive, and nervous systems. Some of these complications can directly or indirectly affect the feet and legs, potentially leading to infection or even amputation. Even though this can be emotional and troubling to a parent, this discussion is necessary to understand the magnitude of the disease and preventative measures.

Good habits with hygiene and inspection can prevent complications such as a foot infection/ulceration. Prevention includes: proper diet, exercise, well maintained glucose control, and proper shoe-gear. If a problem arises in the feet, it becomes a priority to seek the attention of a podiatrist as soon as possible. Maintenance visits to a variety of health care providers, such as endocrinologists, podiatrists, nutritionists/dieticians, pediatricians, and optometrists/ophthalmologists, become essential.

Proper education and preventative measures should become a “Family Affair.” This can lead to normal active lives in mind, body, and feet.