Patients with diabetes have an elevated risk of serious foot problems. There are several reasons for this since diabetes involves: poor circulation, a damaged immune system and the possible development of nerve damage (neuropathy). Blood circulation in the feet is weaker than elsewhere in the body to begin with because of distance from the heart and the force of gravity. Further impaired circulation in diabetic patients may slow healing to a dangerous level.
Causes of Diabetic Foot Problems
Poor circulation makes for slow healing and immune deficiencies allow infections to develop. In addition, diabetic nerve damage may keep patients from sensing heat or injury, and retinopathy which impairs their visual acuity, making detection of injury more difficult. These factors combine to make patients with diabetes highly susceptible to complications from foot problems.
Diabetic neuropathy results from blood sugar levels that are elevated for a long period of time. Nerve damage may sometimes result in pain, but more often results in tingling, numbness, burning, or the inability to experience normal sensation. Diabetics frequently miss the sensory signals, such as extreme temperature or pain, designed to alert the body to possible injury.
Diabetics need to take precautions such as: not walking barefoot, wearing properly fitted shoes, inspecting their feet daily, and carefully treating small injuries, like blisters or calluses, as soon as they appear. It is very important for patients with diabetes to have regular medical and podiatric examinations.
Because even minor abnormalities or injuries may lead to serious complications in patients with diabetes, diabetics need to pay close attention to any and all of the following:
- Ingrown toenails
In diabetics, seemingly inconsequential wounds can quickly become infected or develop into ulcers. Ulcers are wounds that destroy tissue and do not heal on their own. Because patients with diabetes may have poor circulation and skin that is excessively dry, they are more prone to injury. Furthermore, because of nerve damage, they may not feel irritations, such as those caused by ill-fitting shoes, that may lead to such injury. This is why daily inspection of the feet is so important.
Treatment of Diabetic Foot Problems
For patients with diabetes, it is necessary to treat wounds, even small ones, as soon as they are detected. Such wounds often appear on the bottom of the feet, particularly susceptible because they are weight-bearing. Diabetic wound treatment usually follows a protocol that includes:
- Relieving pressure on the affected area
- Cleansing the area thoroughly
- Removing dead skin cells, a process known as debriding
- Applying medication
- Dressing the wound
If a wound is severe, it may be necessary for the patient to wear specially designed footwear, a brace or other device in order to alleviate pressure and promote healing.
Complications of Diabetic Foot Problems
Without proper treatment, diabetic foot problems can have grave consequences, including serious infection of skin or bone tissue. Once tissue becomes necrotic, gangrene can development. If gangrene sets in, amputation may be necessary.
Risk Factors for Diabetic Foot Problems
Apart from the disorder itself, risk factors for diabetic foot problems include:
- Having kidney or eye complications of diabetes
- Having poorly regulated blood glucose
- Having peripheral neuropathy
- Drinking alcohol
- Being overweight
While diabetic foot problems are common, patients with diabetes can usually avoid serious complications through vigilance and early intervention.