When newly diagnosed diabetics are told that they have a serious metabolic disease, one of the last things they think about is their feet. According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), more than 23.6 million Americans have diabetes, and over 15 percent of them have foot complaints serious enough to require hospitalization. Foot complications in diabetics can start with something as innocuous as a blister and ultimately lead to amputation of a limb. In 2004, more than 71,000 nontraumatic lower limb amputations were performed on diabetics.
Overview of Diabetes
Diabetes is a serious metabolic disease that occurs when the body fails to use sugar, or glucose, circulating in the blood. In type 1 diabetes, the pancreas fails to produce enough insulin, causing excessively high levels of blood glucose. High levels of glucose can ultimately lead to kidney failure, nerve disease, blindness or loss of limb. Type 2 diabetics make enough insulin, but their tissues are insensitive to it. In both types of diabetes, the results are the same: the tissues starve in the presence of high levels of blood glucose.
The majority of diabetics are type 2 diabetics. Type 2 diabetics respond well to a regimen of diet, exercise and medication. They do, however, have a number of challenges to contend with, like taking good care of their feet. Diabetics who fail to manage their blood glucose levels experience neuropathy, poor circulation, increased frequencies of infection and ulcers that can ultimately lead to amputation of the affected limb.
Neuropathy
Neuropathy is a diminished sense of sensation in the feet. It can affect a single toe or progress to an entire limb. Because diabetics often lose the sense of touch or sharpness in their feet and limbs, something as simple as a blister can become infected and progress into a much larger problem. They can also experience shooting pains through their feet, causing muscle weakness or foot drop. Foot drop is a complication where they cannot raise their foot enough to walk, which leads to calluses, corns or bunions.
Poor Circulation
Diabetics often suffer from poor circulation in their feet from peripheral vascular disease (PVD), which results in cramps in their feet and calves. There are marked changes in skin color and temperature due to inadequate oxygen delivery to the limbs by the red blood cells. If skin lesions develop or other injuries occur to the feet, the healing process can be slow and require constant monitoring.
Infections
Diabetics typically have problems fighting off bacteria that can often lead to infections from something as small as a cut or bruise. Exacerbating their condition are low white blood cell counts. White blood cells are cells in the blood that help with the healing process.
Importance of Good Foot Wear
While all of these problems seem to spell disaster for anyone with diabetes, there's no need for diabetics to endure foot problems. They must, however, spend more time on their feet and lower extremities and be on the lookout for the first symptoms of problems.
Wearing good shoes is essential to diabetics. Their fit must be perfect, and shoes should be free of sharp seams, torn linings or sharp objects on the inside. Socks should be high quality and made from the type of fabrics that breathe and absorb moisture. Any seam, lining or wrinkle in a sock can irritate the feet and cause the beginning of an open sore or fissure.
Changes in Skin
Diabetics should have their feet inspected every 6 months by their physician or a podiatrist. They'll be looking for changes in the color of their skin, indicating circulation problems. They'll also be able to identify blisters, cuts, bruises and other skin lesions that you may have missed during your regular self-inspections.
Additional Food Care
In between visits to your podiatrist, take care of your feet by frequently massaging them with moisturizer and inspecting them for any new changes. Monitor your blood sugar levels frequently, and call your doctor if they begin to increase from the normal range. Wash your feet daily, and dry them using a clean, dry towel--especially in between your toes. Keep your toe nails trimmed straight across, and avoid cutting them too short. Put your hands inside your shoes and feel for torn linings or seams that could irritate your skin. Finally, avoid walking in your bare feet. Even the slightest cut or bruise could lead to serious problems.
