What are diabetic foot problems?
Diabetes mellitus causes many diseases where high blood glucose of sugar levels may do damage to the kidney, eyes, nerves as well as blood vessels. This disease also causes problems with the ability of the body’s fighting infection. If diabetes is not controlled well, impairment of the system of immunity can occur. For this reason foot problems normally develop in diabetes which can rapidly become severe.
Causes of Diabetic Foot Problems
Because there is injure to the nervous system, a diabetic can not feel the feet properly. Secretion of sweat as well as oil production which keeps the skin on the feet lubricated is impaired. These problems jointly can lead to abnormal pressure on the joints, bones as well as the skin while walking and this causes the break-down of the skin and sores can develop.
Because of constriction of blood vessels and the harm to the immune system from the diabetes, the wounds have problems healing. This leads to infections either bacterial or viral, of the connective tissues, skin, bones as well as muscles and these infections can develop into a condition known as gangrene that is basically dead tissue. The slow flow of blood causes problems with the medications to cure infection getting to the area of the infection. This leads to the only effective treatment being amputation of the leg or foot.
There are several risk factors which can increase the individual with diabetes chances for developing foot problems as well as diabetic infections of the feet and legs.
Footwear
Shoes which are fitted poorly.
Nerve damage
Those diabetics with diabetes that is poorly controlled or have had the disease for a long time have the risk of developing peripheral neuropathy which is nerve damage. Because of this nerve damage, the diabetic is unable to feel their feet. Therefore they are unable to sense any problems which may be injuring their feet for instance minor injuries such as cuts, scrapes, or blisters or any signs of abnormal wear and tear that turn into corns or calluses as well as foot strain.
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Poor circulation
Diabetes can also lead to atherosclerosis or hardening of the arteries. This causes blood flow to injured tissues to be poor so that healing does not properly occur.
Trauma to the foot
Any trauma to the feet can increase the risk for the development of serious problems.
Infections
- Athlete’s foot which is a fungal infection of the toenails or skin can lead to more serious bacterial infections.
- Ingrown toenails need to be treated by a foot specialist.
- Smoking – Smoking causes damage to the smallest blood vessels in the legs as well as feet. Since this can disturb the process of healing, smoking is a major risk factor for gangrenous infections as well as amputations.
Symptoms
- Persistent pain in feet or legs
- Redness on feet
- Swelling of feet or legs
- Warmth which is localized on feet or legs
- Any type of skin break
- Corns and calluses
- Toenail fungus
- Athlete’s foot
- Ingrown toenails
- Pus drainage from a wound
- Bloody drainage which is persistent
- Limping or difficulty walking
- Chills or fever
- Red streaking away from a wound
- Redness spreading out from wound
- New or lasting numbness in feet or legs
A diabetic should see a physician within about 72 hours if they notice any of the below listed symptoms:
- Any injury to the legs or feet which is significant.
- Mild-to-moderate pain which is persistent in legs or feet.
- Any new wound, blister, or ulcer.
- Any new places of redness, swelling or warmth on the feet or legs.
- Pain, swelling or redness surrounding a toenail – could be an ingrown toenail which is the main cause of foot infections as well as amputation for diabetics.
- New or constant numbness in the legs or feet – sign of nerve damage.
- Problems walking can be caused from diabetic arthritis – Charcot’s joints.
- Continued itching of the feet – sign of infection from a fungus or dry skin.
- Corns or calluses – need to be removed by a professional.
- Fever – associated with any of the above symptoms or just fever alone.
The following are some frequent situations that require immediate medical attention for diabetes:
- Relentless pain in the legs or feet is sometimes a sign of sharp circulation loss, severe infection or can be due to nerve damage which is severe.
- Cuts to the legs or feet that significantly bleed and goes all the way thru the skin needs cleansing properly as well as repair to aid healing.
- Any puncture wounds to the feet which is significant – for example stepping on a nail.
- Ulcers or wounds which are more than 1 inch across on the feet or legs can be associated with limb-threatening infection.
- Red streaks or redness spreading away from a wound or ulcer on the legs or feet are a sign of infection.
- Fever more than 101.5 F when connected with swelling, redness, warmth or any ulcer or wound on the legs.
- Alteration in mental status – confusion – can be a sign of life-threatening infection which can lead to loss of a leg or foot especially if associated with a foot ulcer or a leg wound.
Treatment
Self-Care at Home
A diabetic should do the following daily:
- Foot examination – Examine feet daily.
- Eliminate obstacles – Any item you might trip over or bump your feet on,
- Toenail trimming – Always cut your nails with safe clippers – straight across.
- Footwear – Wear sturdy, comfortable shoes. Do not go bare foot. If the diabetic has flat feet, bunions or hammertoes, prescription shoes or shoe inserts may be needed.
- Exercise – Regular exercise improves bone and joint health, improves circulation to the legs and stabilizes your blood sugar levels.
- Smoking – Smoking accelerates damage to blood vessels.
- Diabetes control – A diabetic needs to follow a regimen prescribed by a physician of diet, medications, and exercising.
Medical treatment
- Antibiotics – You doctor will decide if a wound or ulcer on the feet or legs is infected or there is a high risk of becoming infected.
- Referral to wound care center – Some community hospitals have wound care centers specializing in treatment of diabetic wounds in lower extremity as well as ulcers along with other difficult to treat wounds.
- Referral to podiatrist or orthopedic surgeon – You might be referred to a foot specialist if there is bone-related problems, toenail problems, calluses or corns, hammertoes, bunions, flat feet, heel spurs, arthritis or difficulty with finding shoes which fit well.
- Home health care – A home health nurse or aide may need to help with wound care and dressing, monitor blood sugar as well as help the diabetic with antibiotics as well as other medications.