People with diabetes have an increased risk of foot ulcers. A number of other foot problems can occur in people with diabetes such as corns, calluses, bunions, hammertoes, fungal infections, ingrown toenails, and skin dryness. A lot of these problems can be prevented with controlled blood sugar levels and appropriate foot care.

Why do diabetics have problems with their feet?

In people with diabetes, foot complications from nerve damage and circulation problems can make healing from cuts, sores, cuts, ulcers difficult. The slow healing in turn can lead to infections. Also, because of nerve damage, diabetics may not immediately notice any problems or sores on their feet.

Over time, nerve damage or diabetic neuropathy can lead to foot problems that cannot be healed and may lead to amputation.

What foot problems can be caused by diabetes?

Diabetes mellitus can lead to neuropathy or loss of normal nerve function and peripheral vascular disease or loss of normal circulation. These conditions can lead to

A 47-year-old diabetic patient with profound peripheral neuropathy developed a blister on the plantar aspect of her right heel that became recalcitrant to conservative treatment. By Jonathan Moore, via Wikimedia Commons

1. Diabetic foot ulcers. These are open sores or wounds that atcommonly located on the bottom of the foot. These are wounds that do not heal or become infected.
2. Charcot arthropathy. This is also known as Charcot foot and ankle. This occurs in patients who have neuropathy or loss of sensation, including fractures and dislocations of bones and joints that occur with minimal or no known trauma.​
3. Cellulitis. This skin infection happens when bacteria spread through the skin to deeper tissues. In diabetics, it can sometimes progress to a more serious infection, causing severe infection (sepsis) or other dangerous problems.
4. Osteomyelitis. This is a bone infection, usually caused by bacteria. It is estimated that one out of five patients with diabetes who have foot ulcerations will develop osteomyelitis. This often results from the spread of a foot infection to underlying bone.
   

   Diabetic ulceration with central “dry” gangrene and, toward the edges, wet gangrene with some ascending cellulitis. By Taken in my medical practice by DrGnu, via Wikimedia Commons

5. Gangrene. This is the most dreaded diabetic foot problem. There is death or decay of the affected tissues of the foot. Gangrene usually affects those patients with high and uncontrolled blood sugar levels.

How does diabetes affect the feet?

Uncontrolled diabetes results in poor blood flow to certain areas of the body, especially the legs and feet, which makes it harder for the body to heal injuries. Diabetes causes nerve damage that makes it difficult to notice any wound or injury that needs treatment.

Warning signs of diabetic foot problems

See your podiatrist right away if you experience any of these symptoms:

• Tingling, burning of the feet
• Loss of sense of touch, not able to feel heat or cold very well
• Fungal infections such as athletes foot, toenails turning thick and yellow
• Dry and cracked skin on the feet
• Change in the shape of the feet

Statistics

In 2012, 9.3% of Americans had diabetes. The percentage of Americans age 65 and older remains high at 25.9%.

Amputations in adults with diabetes account for about 60% of the amputations of legs and feet not resulting from an injury, such as from a car crash. Among those aged 45 years or older, people with diabetes were about ten times as likely to lose a leg or foot to amputation as people without diabetes, according to CDC research.

The fact that the number of amputations continue to rise is a huge concern because of the devastating impact they have on people’s lives. A lot of these amputations are preventable, and diabetics must understand that the risk of amputation is real. People with diabetes must go for at least an annual foot checkup with their podiatrist.

What will your podiatrist tell you?

Your doctor will analyze and determine your level of risk. An individual plan will be devised for your foot condition which may involve advice on footwear, diet, how to protect your feet, how to notice warning signs, and treatments for any foot condition. You will be scheduled for foot checkups as needed, in addition to annual diabetes foot check.

Learn how to look after your feet and get help immediately if you notice any foot problem by visiting us at NaplesPodiatrist.com

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