Why is it important for diabetic patients to check/inspect their feet?

My daughter asked me this questions just the other day on our way to an event. Two reasons why it is important for the diabetics to have a yearly foot exam: First, circulation issues, and second, neuropathy or impaired sensation in the toes or feet. Let me explain. Diabetes affects both the small and large blood vessels in the body by increasing the thickness in the vessel wall which in turn slows down or occludes the blood flow to the feet. Without adequate blood flow, the tissues in the feet lack proteins, nutrients, and oxygen which leads to damage or necrosis (gangrene) therefore resulting in loss of a digit or limb. Diabetes over time can also affects sensation/ what we feel, starting in the toes and work its way up the foot. There are different levels of sensory impairment including burning, numbness, pain or ‘a pins and needles’ feeling. Over time besides a sensory neuropathy a patient may develop a motor neuropathy which affects the muscular movement in the feet which in turn can lead to foot deformities. By keeping blood sugar (Glucose) levels under control and following up with a podiatrist on at least an annual basis will help prevent or prolong foot complications. -Dr. Musser