Diabetic patients are highly prone to foot problems due to prolonged duration of uncontrolled blood sugar levels. Diabetic neuropathy and peripheral vascular disease are the common foot problems that develop and both can result in serious complications. Foot ulcers are formed as a result of skin tissue breaking down and exposing the layers underneath, including toes, balls of the feet and also affect feet down to the bones.
Good foot care and controlling blood sugar spikes can help avert diabetic foot infections. Treatment of diabetic foot ulcers depends upon causative factors. Seek immediate medical attention for any foot pain or discomfort to ensure it’s not a severe problem, as infected ulcers can result in amputation if left untreated.
Common Foot Problems
Prolonged diabetes can cause nerve damage that leads to loss of sensation or numbness in the feet, which makes it hard for diabetic patients to feel sensation in their lower extremities. This condition also makes it difficult for diabetic patients to feel irritation or soreness on the feet. The poor sensation can increase the risk of cuts, sores and blisters. If prompt treatment is not given for infection it may lead to ulcers and even gangrene.
Peripheral Vascular Disease
Diabetes also leads to changes in the blood vessels including arteries. In peripheral vascular disease, fat gets build-up in the blood vessels beyond the brain and heart. It usually affects blood vessels in the extremities such as hands and feet lowering the blood flow. Poor blood circulation can lead to pain, infection and wounds that heal slowly.
The symptoms of foot infection may vary from person to person depending upon the nature of the issues. Some of the common symptoms include:
Loss of sensation or feeling
Blisters or wound without pain
Skin discolouration and temperature changes
Wound without draining
If an infection develops a person may also experience below symptoms
High blood sugar
Diabetic patients who suffer from infection especially on the feet should seek immediate medical treatment to avert complications or amputation.
Diabetic neuropathy and peripheral vascular disease are severe conditions that need proper medical care and follow-ups. Both can cause complication that can have severe negative impacts which include:
Infections in the skin, bone and abscesses
Gangrene, where an infection leads to tissue death
Charcot’s foot, where the shape of the feet is altered due to the breaking of bones in the foot or toe shift.
When To Seek Medical Help?
Diabetic patients should visit a doctor as part of their routine follow-ups, however, if they notice any of the following changes should seek immediate medical help:
Colour changes on the foot
Swelling in the foot or ankle
Temperature changes in the feet
Constant sores on the feet
Pain or tingling in the feet or ankles
In growing toenails
Athlete’s foot or any fungal infections
Dry, cracked skin on the heels
Signs of infection
The mode of treatment for diabetic foot problems varies according to the severity of the problem. Both surgical and nonsurgical options are available.
In most cases, the doctor will initially attempt to treat diabetic foot problems without surgery. Some of the non-surgical treatment methods include:
Cleaning and dressing wounds well
Recommending immobilization devices like cast boot or total contact cast
Closely monitoring gangrene on toes
The doctor may consider surgery when nonsurgical treatment does not successfully heal foot problems. Surgical options include:
Removal of dead or decayed tissue
Amputation, ranging from single toes or part of the foot to amputation of the leg below or even above the knee.
Surgical stabilization of Charcot's Foot
Arterial bypass procedure to treat PAD, which helps proper blood flow
Endovascular surgery with placement of stents, which uses small devices to clear clogged blood vessels and keep them open.
Diabetic Foot Care Management
Preventing foot infections is vital for all diabetics, maintaining feet in good condition is important and a person should be cautious about proper foot hygiene. Follow these precautionary measures to avert the risk of foot infections which include:
- Monitor the feet every day- examine or seek someone help to check for any changes or injuries.
- Wash and clean the feet daily to prevent infections and keep it dry.
- Wear supportive shoes or socks at all times as per the podiatrist recommendation to prevent deformities. Do not wear tight socks that may impede blood flow.
- To ensure proper blood circulation to the feet-keep the feet elevated while sitting, do ankle toe movements regularly and get proper exercise, as these would improve healthy blood flow to the feet.
- Trim toenails straight across and keep them short, rounded nails can grow inward, resulting in infection.
- Treat corns and bunions properly, never cut or trim corns, as this may increase the risk of infection.
- Safeguard feet from both extreme hot and cold temperatures as this could harm the feet.
- Maintain blood sugar levels under control, as high blood sugars elevate the risk of feet complications