Foot Problems in Diabetics

Both types of diabetes can cause damage to peripheral nerves and blood vessels which can result in foot and leg problems. That’s why having certain diabetes complications raises the risk of getting major foot problems if not managed promptly.

Diabetes-related foot problems most often occur when there are such complications as:
Neuropathy. Nerve damage in the feet and lower legs, called peripheral neuropathy. This can cause tingling, stinging, burning and weakness in the foot. Despite the fact it can hurt, nerve damage decreases sensation in the nerves of extremities and lessens the ability to feel pain, cold, heat and perceive injuries. For example, you may get a blister but not feel it or notice an injury until the skin breaks down and becomes infected.

Diabetic neuropathy can also cause feet muscles to work improperly, resulting in foot misalignment that can put pressure on certain areas of the foot. This leads to foot deformity, causing changes in the shape of the foot and toes, called Charcot’s foot. The condition may start with warmth, redness and swelling and with time progress to foot bones shift or break, eventually resulting in disability.

Calluses. Abnormal alignment of the feet as well as abnormal gait in diabetics may lead to development of corns and calluses because of high pressure areas under the feet. If not trimmed, calluses get very thick, break down and turn into open sores.

Skin changes. Diabetes may cause the skin of the feet to become very dry. It may peel and crack, especially on the heels, because the nerves that control moisture and oil in the feet are damaged and no longer work.

Poor blood circulation. Diabetes causes blood vessels of the lower extremities to narrow and harden. This lowers the amount of blood in the feet, making it difficult for an infection or a sore to heal. When wounds heal slowly, they have more time to become infected. Sometimes, a bad infection never heals, leading to foot ulcers or gangrene.

Wounds and ulcers that don’t heal with treatment require amputation of a toe, foot or a part of the leg in order to prevent infection from spreading to the rest of the body. However, most amputations are preventable with proper footwear and regular care.

Fungal infections. Diabetics are at increased risk for fungal infections of the nails, which can manifest as thickened, discolored and brittle nails, often with a yellow shade. Fungal foot infection occurs in 1/3 of diabetes patients and increases the risk of developing diabetic foot syndrome .

Very often people with diabetes do not notice that they have already developed a foot problem. Apart from blood glucose control, foot care is very important in preventing serious infections and complications. Therefore, it is important to check your feet daily to spot the problems before they get worse.

  • Wear well-fitting shoes at all times and always check inside them for foreign objects to protect your feet from calluses and ulcers. Too much callus may mean that you need special inserts and therapeutic shoes.
  • Wash your feet daily paying more attention to the areas between your toes which often stays moist, allowing infection to spread. Dry these areas well and use powder to keep skin dry and prevent an infection.
  • Everyday use of pumice stone on wet skin helps keep calluses under control. Never use chemical agents to remove them as these products can burn the skin.
  • Apply first-aid measures to blisters and cuts and check daily to see if the wound is healing. If it is not, call your healthcare provider promptly to prevent a more serious complication.
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