Diabetes and Foot Problems: What Diabetes Can Do to Your Feet


Diabetes in the US is widespread. Over 30 million Americans (about 10% of the population) have it. Over 25% of Americans over the age of sixty-five have it. It’s the seventh leading cause of death in the US. And experts agree these statistics from the American Diabetes Association may actually underreport the prevalence of diabetes in the US.

How does diabetes affect the feet?

Insulin is a hormone that is vital to maintenance of healthy metabolic activity. It enables cells to absorb sugar from the blood, and then convert that sugar into energy. Diabetes impedes the body’s ability to produce insulin and to utilize whatever insulin is produced.Diabetes foot

When diabetes reduces the body’s ability to either produce insulin or use it to create energy, excess sugar continues to circulate in the bloodstream. Overabundant blood sugar causes multiple types of health problems. Two of those problems primarily affect the feet.

The two primary foot problems caused by diabetes are diabetic neuropathy and peripheral arterial disease. More than 50% of diabetics have one or both of these potentially serious conditions.

Diabetic neuropathy and peripheral arterial disease often combine to cause severe health problems that, if not promptly treated, can lead to gangrene, amputation, or even death.

What is diabetic peripheral neuropathy?

Diabetic neuropathy is called peripheral because it occurs in the extremities, away from your body’s core organic structures.

Excess sugar in the blood stream is especially likely to degrade nerve cells in the feet. This impairs the nervous system’s ability to report pain to the brain. The decreased sensitivity can make it difficult or even impossible to become aware of injuries to your numb feet.

What does neuropathy feel like?

In addition to nerve damage, excess sugar in the blood stream causes nerve cells to import water. This causes the nerve cells to swell, which in turn causes compression of the nerve tissue itself. The initial symptoms of diabetic peripheral neuropathy are numbness and tingling.

Medical science has not yet discovered how to prevent the onset of diabetic neuropathy, but methods are available to slow or even halt its progression. This is accomplished by releasing the compression that affects both nerves and blood vessels.

When surgical decompression is performed early in the course of diabetic neuropathy, blood flow can be restored. This will alleviate the numbness and tingling and help the nerves to recover.

What is peripheral arterial disease (PAD)?

Diabetes increases the risk of developing atherosclerosis, a condition commonly known as hardening of the arteries.

The arteries serving the feet become narrowed or even blocked by atherosclerotic plaque, composed of cholesterol, fat, and other substances found in the blood. Because of the hardening of the arteries, blood flow to the feet is diminished.

Neuropathy and PAD can cause the following diabetic foot complications:

Foot ulcers (open sores on the feet)

Foot ulcers are the most common diabetic foot complication. They occur in 15% of patients. Because of poor circulation and the loss of sensation caused by neuropathy and PAD, minor injuries can go unnoticed and untreated. Blisters and sores may provide an opening for bacteria and consequent infection. When these go untreated for significant periods of time, gangrene (tissue death) can occur. Severe cases can necessitate amputation of all or part of the foot.

Treatment of diabetic foot ulcers includes noninvasive remedies, designed to eliminate the pressure and friction that cause the ulcer. Stem cell therapy harnesses the body’s own healing power to heal foot ulcers.

As a last resort, your foot doctor may advise surgery for resolution of otherwise intractable diabetic foot ulcers.

Diabetic osteomyelitis in the feet

This is a bone infection that often begins as a foot ulcer and then invades the bone structure of the feet. Because of the combined effects of neuropathy and PAD, the infection progresses unnoticed.

Osteomyelitis is often responsive to a course of antibiotic treatment. When antibiotics are ineffective, surgical removal of the affected portions of the foot may be required.

Charcot foot syndrome

Sometimes diabetic neuropathy and peripheral artery disease can jointly cause softening of the bones in the foot. This makes the bones readily subject to fracture. The resulting bone disintegration can severely deform the foot’s configuration. Although rare, this condition is one of the most serious that can confront diabetics.

The most effective treatment for Charcot foot syndrome is to prevent it before it occurs. Diabetics should carefully inspect their feet for cuts or injuries each and every day.

Nonsurgical care for diabetic Charcot foot includes eliminating any weight-bearing and wearing a protective splint, walking brace, orthotic. Severe cases of Charcot foot require installation of hardware (plates and screws) to restore an appropriate structure to the foot.

How to care for diabetic foot problems

Diabetes footDiabetic neuropathy and PAD interrupt the nerve signals to the brain. This means that diabetics often obliviously suffer serious complications with their feet. Constant vigilance is the answer. If you are diabetic, check your blood sugar levels daily and take care of your feet.

  • Check your feet each day for anything unusual. Look for cuts, redness, swelling, sores, blisters, or any other foot infections.
  • Wash your feet every day in warm, not hot water. Dry your feet completely and apply lotion to the top and bottom (not between the toes, which can promote infection).
  • Never go barefoot. Always wear shoes and wear socks, even indoors, make sure that there are no objects inside your shoes and that the shoe’s lining is smooth.
  • Make sure your shoes fit perfectly. Get fitted for new shoes at the end of your day, when your feet have expanded.
  • Trim your toenails straight across, and gently smooth any sharp edges.
  • Get expert help in dealing with corns and calluses, and don’t use over-the-counter products to remove them.
  • Have a regular diabetic foot exam with your doctor.
  • Keep the blood flowing. Elevate your feet when you’re sitting, flex your feet and wiggle your toes for a few minutes several times throughout the day.
  • Give your feet some exercise by walking, riding a bike, or swimming.
  • Don’t smoke (this is good advice in any context).
  • Work with your healthcare team for good diabetes care.

Why choose University Foot and Ankle Institute for diabetic foot care?

If you’re experiencing issues with diabetic feet, or any other foot problems, we’re here to help. Our nationally recognized foot and ankle specialists offer the most advanced podiatric care and the highest success rates in the nation. We are leaders in the research and treatment of all foot and ankle conditions.

For more information or to schedule a consultation with a podiatrist, please call (877) 736-6001 or make an appointment online now.

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