Having diabetes can lead to many serious complications. These complications can be debilitating and cause long term disability. It is common for diabetics to have complications with their feet. According to the National Diabetes Education Program, diabetes is the leading cause of amputations to the lower extremities, although preventative measures reduce this risk.
Risk Factors
Neuropathy is a condition where the nerves of the feet become damaged. This can result in a loss of sensation in the feet. In addition, persons with diabetes may also have poor circulation, which can make it more difficult for wounds to heal. Having poor blood glucose control can impair healing. Smoking can lead to poor circulation, so it is never advisable to smoke.
Problems that Can Develop
Persons with diabetes may have very dry skin, particularly on the feet. Foot ulcers are open wounds that develop on different areas of the feet. They can be on the sides of the foot, the ball of the foot or even between the toes. Infected ulcers or ulcers that are not healing can lead to an amputation of part of or all of the foot. Diabetics with poor circulation are more at risk for amputations.
Preventive Measures
Keeping the feet clean and well moisturized can help keep them healthy. Moisturizer should not be applied between the toes, since that can trap moisture and encourage infection. Wearing clean, dry socks and shoes that fit well is important for diabetics. Shoes that fit poorly can lead to friction and damage to the foot, which can lead to a foot wound or ulcer. Since some diabetics experience neuropathy, it is important to check the feet daily, including between the toes and the bottom of the feet for any open areas or areas of concern. Cutting toenails appropriately or having a podiatrist cut toenails is also important. Getting evaluated by a doctor for any foot injury is critical.
Impact of Foot Problems
Thirty percent of those with diabetes forty and older have impaired sensation in their feet. The American Diabetes Association reports that 60 percent of nontraumatic lower-limb amputations occur in people with diabetes, The good news is, that comprehensive foot care programs can reduce amputation rates by 45 to 85 percent, according to the Centers for Disease Control and Prevention.
Physician's Role
It is important to discuss diabetic foot ulcer prevention at every visit with the doctor. In addition, feet should be inspected at every doctor's visit, and at least twice a year for high risk individuals according to the National Diabetes Education Program. The physician can assess for risk factors, inspect for any signs of foot injury or ulcer, circulation or problems with sensation.
References
- American Diabetes Association: Foot Problems
- National Diabetes Information Clearinghouse: Preventing Diabetes Problems Keep your Skin and Feet Healthy
- Centers for Disease Control and Prevention: National Diabetes Fact Sheet
- National Diabetes Education Program: A Healthcare Provider's Guide to Preventing Diabetic Foot Problems
