Tens of thousands of Americans across the country are joining the American Diabetes Association to raise awareness of diabetes; and to inspire over 30 million children and adults who have diabetes to live a healthy and active lifestyle. An additional 86 million people are estimated to have pre-diabetes. Recent estimates project that one in three American adults will have diabetes in 2050 unless measures are taken to stop diabetes.
Diabetics have a higher risk of developing foot problems than non-diabetics. These problems relate to peripheral neuropathy, peripheral vascular disease, foot ulcers, skin changes, calluses, toenail fungus, foot deformities, and amputation.
Peripheral neuropathy is the predisposing factor for diabetic foot complications and the development of foot ulcers. It is a progressive and irreversible disease that damages the nerves and lessens ability to sense heat, cold, and pain. The loss of feeling leads to injuries like blisters and infection. It also affects moisture in your skin causing dryness and cracking. Unhealed sores can turn into gangrene and lead to amputation. Nerve damage can lead to changes in the shape of your toes and feet.
Peripheral Vascular Disease
Diabetes damages the blood vessels and leads to poor blood flow to the lower extremities. As the blood vessels narrow and harden, it makes it more difficult to fight infection and heal. Poor circulation decreases sensation making it difficult to gauge temperatures. Walking can cause intermittent claudication (pain in calve muscle). The combination of peripheral neuropathy and vascular disease cause major problems. Unhealed sores can turn into gangrene and amputation.
Ulcers usually appear on the bottom of the feet. Treatment depends on the nature of the ulcer. X-rays can determine if bone is infected. The site can be cleaned by removing dead tissue and antibiotics may be administered. Treatment by a vascular surgeon may be necessary if an ulcer is due to poor circulation. Special treatment may be required if a wound fails to heal. Special therapeutic shoes are usually prescribed to prevent ulcers.
The nerves that control moisture and oil production in the foot are flawed. Consequently, skin becomes dry and prone to crack and peel.
Diabetics are prone to calluses because there are high-pressure areas under the foot. Often they turn into open sores if they are not properly treated in a timely fashion. Improper removal of calluses and corns with chemical agents or unsterile tools can lead to serious consequences. Skin moisturizers need to be carefully applied to avoid infection.
Toenail fungus can lead to further infection and complications for diabetics if left unchecked. It can also lead to complications if it is in conjunction with an ingrown toenail. There is wide range of conventional treatments and medications available with varying success rates. New laser treatments are available and have higher success rates (70-80 percent) of eradicating the fungus with no side effects from medications.
Foot deformities such as hammertoes, claw toes, and bunions can increase the risk of calluses, corns, blisters, ulcers, and infections. Increased friction from shoes can cause problems. Therapeutic shoes are prescribed to accommodate changes in foot shape. In some cases, operative treatment is necessary.
Diabetics have a much higher chance of having their foot or leg amputated than non-diabetics because peripheral arterial disease (PAD) restricts blood flow. About 73,000 lower-limb amputations were performed in 2010.
Most of us pay little attention to our feet compared to other parts of our body. This is a problem, especially if you have diabetes. Regular inspection of your feet is essential on a daily basis. It won’t cost you a nickel and it is one of the best ways to prevent foot complications. There are many other things you can do to care for your feet. Here are some tips:
- Wash your feet daily
- Keep circulation flowing in your feet when inactive
- Be active and exercise regularly
- Always protect your feet by wearing socks and shoes
- Protect your feet from extreme temperatures
- Moisturize your skin regularly
- Trim your nails carefully
- Wear comfortable shoes that fit properl
Annual examinations by your podiatrist are essential for any non-wound person with diabetes. Frequent visits may be required for the treatment of open wounds or more chronic conditions.
Ask your podiatrist about Medicare’s Therapeutic Shoe Program for diabetics. This is a fantastic program and one of Medicare’s successes. The program provides one pair of diabetic shoes and three pair of special sole inserts every year for free. The shoes and inserts will help prevent a callus and ulcer from developing. Eligibility requirements require a medical confirmation that you have a foot ulcer, nerve function problem, reduced blood flow, previous amputation, or foot deformity such as a hammertoe, claw toe, or bunion. Prescription shoes are a safe and effective way to minimize your risk of chronic problems.
Podiatric technology continues to advance every day. Many of the recent innovations in wound care/operative care are bringing new hope to diabetics.
Contact Dr. Sigle at the Foot & Ankle Center of Illinois if you are interested in learning more about wound care advancements for chronic ulcers, and cutting edge pain free lasers to treat skin grafts, ulcers, wounds, and diabetic neuropathy. Dr. Sigle has clinics in Springfield and Decatur. Call 217-787-2700 for an appointment or visit myfootandanklecenter.com.
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