This eye-opening article explains how plantar fasciitis, high blood sugar, and future health risks like atherosclerosis and kidney dysfunction are interconnected and why knowing this can protect your overall health.
Introduction
Plantar fasciitis, often seen as a simple cause of heel pain, might reveal deeper health problems.
Research shows that this condition could predict future complications, particularly in people with diabetes or high blood sugar (hyperglycemia).
But even those without diabetes—like people with prediabetes or those without diabetes who have recurring high blood sugar—can develop plantar fasciitis due to the damaging effects of elevated glucose levels.
Understanding the Plantar Fascia and Enthesopathy
The plantar fascia is a thick band of connective tissue that runs along the bottom of the foot. It supports the arch and absorbs the shock of daily activities like walking and running. When this tissue becomes inflamed or damaged, it causes heel pain, known as plantar fasciitis.
Enthesopathy, which refers to abnormalities or diseases at the site where tendons or ligaments attach to bones, can also occur.
In plantar fasciitis, enthesopathy leads to thickening, stiffness, and structural damage in the plantar fascia.
Prolonged high blood sugar levels, which disrupt the collagen in the connective tissue, often cause enthesopathy.
How Hyperglycemia Affects the Plantar Fascia
Hyperglycemia (high blood sugar) can harm tissues in several ways:
Advanced Glycation End Products (AGEs):
-
- High glucose levels attach to proteins like collagen, forming AGEs.
- AGEs make tissues like the plantar fascia stiffer, weaker, and prone to injury.
Inflammation:
-
- Hyperglycemia triggers chronic inflammation, contributing to enthesopathy and heel pain.
Circulatory Damage:
-
- Poor foot circulation, common in diabetes and prediabetes, impairs healing and increases tissue vulnerability.
Plantar Fasciitis in Non-Diabetics
Even people without diabetes can develop plantar fasciitis if they experience recurring high blood sugar spikes after meals (postprandial hyperglycemia) or have prediabetes. These conditions lead to:
- Formation of AGEs: Just like in diabetes, AGEs accumulate and damage the plantar fascia.
- Microvascular Changes: Early blood vessel damage reduces nutrient delivery to tissues, impairing health.
- Increased Risk of Systemic Issues: Chronic hyperglycemia is a precursor to diabetes and can signal underlying problems.
Recognizing plantar fasciitis as a possible warning sign in these individuals may help prevent more severe health issues.
Health Complications Linked to Plantar Fasciitis
1. Retinopathy (Eye Damage):
Retinopathy refers to damage to the small blood vessels in the retina, the part of the eye that senses light and allows you to see.
Hyperglycemia can weaken these vessels, causing them to leak or close off, leading to vision problems or blindness.
Research published in Diabetes Care (2008) shows that people with thickened plantar fascia are more likely to develop retinopathy, as both conditions are linked to tissue glycation and poor blood sugar control.[1]
2. Reduced Renal Filtration (Kidney Damage):
The kidneys filter waste and excess fluid from the blood. When hyperglycemia damages the kidney’s filtration system, the glomerular filtration rate (eGFR) is reduced.
This damage causes waste products to accumulate in the blood, increasing the risk of kidney disease and failure.
A study published in Plos One (2017)indicated that reduced renal function often coexists with plantar fascia abnormalities, highlighting the need for early detection.[2]
3. Cardiovascular Disease (CVD):
Hyperglycemia and inflammation in plantar fasciitis increase systemic markers like C-reactive protein (CRP), a strong indicator of heart disease.
A recent study published in Cureus (2024) showed that Elevated CRP levels correlate with atherosclerosis (hardening of the arteries), which raises the risk of heart attacks and strokes.
What These Findings Mean for You
The studies collectively show that plantar fasciitis is more than just heel pain—it’s often a signal of deeper health concerns tied to high blood sugar, including:
- Microvascular complications like retinopathy and kidney disease.
- Systemic inflammation leading to cardiovascular risks.
- Tissue glycation and damage from hyperglycemia.
This makes plantar fasciitis a potential early warning sign for metabolic problems, even in people without diagnosed diabetes.
Prevention and Management
To protect your feet and overall health, it’s essential to address the root cause: hyperglycemia. Here’s how you can manage and prevent complications:
1. Monitor and Control Blood Sugar:
- For Diabetics and Prediabetics: Regularly monitor blood sugar levels to ensure they remain within a healthy range.
- For Non-Diabetics: Avoid frequent blood sugar spikes by choosing low-glycemic index foods and avoiding sugary drinks.
2. Adopt a Balanced Diet:
- Focus on whole foods like vegetables, lean protein, whole grains, and healthy fats.
- Avoid refined carbohydrates and processed foods, which cause rapid glucose spikes.
3. Exercise Regularly:
- Physical activity improves insulin sensitivity and helps regulate blood sugar.
- Weight-bearing exercises can also strengthen the plantar fascia and reduce heel pain.
4. Address Inflammation:
- Incorporate anti-inflammatory foods like omega-3-rich fish, nuts, seeds, and green leafy vegetables.
- Manage stress through relaxation techniques like yoga or meditation, which can reduce inflammatory markers.
5. Manage Weight:
- Excess weight increases the strain on the plantar fascia and contributes to higher blood sugar levels. Maintaining a healthy weight can reduce the risk of both plantar fasciitis and hyperglycemia.
6. Regular Check-Ups:
- If you experience recurrent plantar fasciitis or have other risk factors, get routine screenings for blood sugar, kidney function, and cardiovascular health.
Conclusion
Plantar fasciitis is often dismissed as a minor foot problem but can be a red flag for broader health concerns.
Whether you have diabetes, prediabetes, or recurrent postprandial hyperglycemia, this condition may signal underlying issues like tissue glycation, systemic inflammation, and cardiovascular risks.
Recognizing the connection between plantar fasciitis and systemic health can help you take early action to manage blood sugar, reduce inflammation, and protect your overall health.
If you experience persistent heel pain, consider it an opportunity to check your metabolic and cardiovascular well-being.
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Related:
- Trigger Finger and Its Alarming Relationship with High Blood Sugar
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- 102 Easy Ways to Lower Post-Prandial Blood Sugar Without Meds
- Applying The OODA Loop For Better Health
- Prevent Hypoglycemia with Smart Medication Adjustments
- The Simple Way To Keep Blood Sugar Low: Breakfast
References:
- Craig ME, Duffin AC, Gallego PH, Lam A, Cusumano J, Hing S, Donaghue KC. Plantar fascia thickness, a measure of tissue glycation, predicts the development of complications in adolescents with type 1 diabetes. Diabetes Care. 2008 Jun;31(6):1201-6. doi: 10.2337/dc07-2168. Epub 2008 Mar 10. PMID: 18332152.
- Ursini F, Arturi F, Nicolosi K, Ammendolia A, D’Angelo S, Russo E, Naty S, Bruno C, De Sarro G, Olivieri I, Grembiale RD. Plantar fascia enthesopathy is highly prevalent in diabetic patients without peripheral neuropathy and correlates with retinopathy and impaired kidney function. PLoS One. 2017 Mar 30;12(3):e0174529. doi: 10.1371/journal.pone.0174529. PMID: 28358891; PMCID: PMC5373572.
- Elabd K, Basudan L, Alomari MA, Almairi A. Plantar Fasciitis as a Potential Early Indicator of Elevated Cardiovascular Disease Risk. Cureus. 2024 Jun 9;16(6):e62007. doi: 10.7759/cureus.62007. PMID: 38983990; PMCID: PMC11232916.
Image Credit: Plantar fascia: Public Domain, https://commons.wikimedia.org/w/index.php?curid=112670252
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