How is Diabetes related to Foot Conditions?
patients are particularly at risk for significant foot
problems that can lead to the loss of their feet or legs. The
most common cause of hospitalization for he diabetic patient
is foot infections. Foot related problems for the diabetic
patient are responsible for significant time off work. Foot
ulcerations can take weeks or months to heal.
There are two conditions associated with
diabetes that put the
patient at risk. The first is called neuropathy, a nerve condition
that frequently affects the feet. There is a gradual loss in
the patient's ability to feel sharp touch or pain. As the protective
sensation is lost, the patient cannot feel the difference between
hot and cold, sharp and dull, vibration or excessive pressure.
This loss of sensation can become quite profound. Patients can
step on sharp objects or cut themselves and not feel pain. They
may burn themselves with scalding water and not be aware of it,
and they can develop pressure sores and infections and experience
little or no pain.
Because of this condition, diabetic patients
must be constantly be aware of their feet and inspect them daily. They should avoid
walking barefoot and avoid hot showers or baths. The temperature
of the shower or bath water must be checked, usually with the
elbow rather than the hand, prior to immersing the feet. It may
be a good idea to have the water heater temperature lowered to
prevent accidental burns. Avoid soaking the feet since this dries
the skin and may cause cracking, leading to infection. Special
care should be taken when trimming the toenails. Avoid sharp
trimming of corns and calluses and over-the-counter corn removers.
Shoe gear must be appropriately fitted to avoid areas of irritation.
Frequently this condition causes a burning pain that makes sleeping
difficult. Some patients may feel like their feet are ice cold
and have difficulty warming them. Avoid using heating pads or
hot water bottles to warm the feet since this can cause burns
to the skin that may not heal and could lead to the loss of their
foot or leg.
The second condition is a loss of circulation that can cause
delay in healing of cuts or sores on the feet. In severe cases
it can lead to gangrene and amputation. When present the skin
may appear to be thin, hair growth on the foot or leg stops.
In Caucasians the skin color turns reddish or blue. The feet
are cool to the touch and can be very sensitive, making it painful
to walk, even short distances.
Common problems the diabetic may encounter are ingrown or fungal
toenails, thick calluses on the bottom of the feet and corns
on or between the toes. Even these relatively simple problems
can lead to serious complications and problems for the diabetic.
We recommend that the diabetic patient have their feet checked
on a regular basis, by a podiatrist. Skin irritation, sores and
infections the patient should seek professional treatment by
their podiatrist. If the foot appears to change shape, the arches
appear to be falling or sudden onset of swelling is seen, please
consult your podiatrist. The diabetic patient's best defense
against problems including infections and possible loss of feet
or legs is to inspect the feet daily and have regular foot exams.
Keeping your blood sugar under control helps to minimize the
development of problems and allows problems to heal faster when
they occur. Check your blood sugar daily and see your medical
doctor routinely. For more information about diabetes you can
contact the American Diabetes Association at 1-800-DIABETES (343-2383)
or visit their web site at http://www.diabetes.org.