If you have diabetes, you have been told repeatedly how important it is to control your blood sugar levels. You watch your diet closely, avoid sugar spikes and monitor your use of medication to keep the level as stable as possible. Unfortunately, despite your best efforts, you may still end up sustaining damage to the nerves in your legs and feet. Nerve damage usually first occurs in the tiny ends of the nerves near the skin layer (epidermis), so the epidermal nerve fiber density test can be an important tool to determine the extent of the problem.
The test involves taking a small sample of skin, usually from a spot several centimeters above your ankle bone, to send for analysis. Because the biopsy is so small and thin, there is little room for error to keep the sample undamaged. The test is fairly simple and can be performed in the office, but special procedures and a special fixative, rinse, and shipping solution must be used to prevent damage to this fragile sample.
Your doctor will clean the biopsy area with alcohol, use a local anesthetic, and then a special punch about the size of a small straw is gently inserted into the skin. After it is pulled out again, the thin layer is gently lifted and detached. An application of triple antibiotic cream is applied, and a bandage completes the procedure.
The test determines how serious your nerve damage is, and it guides the decision about possible treatments. When your nerves don’t function properly, they can’t warn you about heat, cold, or an injury. Due to this, a small sore can go unnoticed and develop into a worse condition.
Treating the foot and ankle sores that often accompany diabetes is one of our specialties at the Fixing Feet Institute in Surprise, AZ. Dr. Peyman Elison sees many patients with these problems and has the expertise to help keep your feet as healthy as possible. Call us at the first sign of foot injury at (623) 584-5556, and head off complications before they start!
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