While taking care of your feet is always important, it's particularly important if you have diabetes. Because diabetics often have circulation problems and a decreased ability to fight off infection, foot problems can develop quickly and cause serious problems. Bunions occur when your big toe is pushed toward your other toes. Extra bone grows around the big toe joint, which often becomes painful and swollen. Infection in the joint can occur. While foot surgery can repair bunions, foot surgery has special risks for people with diabetes.
Causes
People with diabetes are prone to foot problems for several reasons. Nerve damage may cause people with diabetes to walk with an abnormal gait, which puts pressure on the bones and joints in the foot. Since neuropathy disrupts feeling in the feet, a person with diabetes may not notice that she's walking oddly. Tight shoes can worsen bunions; a diabetic may not realize her shoes are too tight because she can't feel her feet well and doesn't recognize the pain from too-tight shoes. Around 90 percent of bunion-sufferers are women, who are also more likely than men to squeeze their feet into tight shoes, according to the American Academy of Orthopedic Surgeons. Poor blood flow to the feet can also increase the risk of developing in an infection in the inflamed toe joint.
Surgical Care
People with diabetes are prone to complications during surgery. Special care must be taken to keep blood sugar levels under control during and after surgery. Infection is more likely to occur, along with poor wound healing due to decreased blood flow and neuropathy.
Post-Surgical Care
After foot surgery, a person with diabetes must watch for signs of infection or other complications. Pins holding the bones in place require careful cleaning to avoid infection around the site. Since a person with diabetes may not feel the pain from infection, daily visual inspection of the foot and leg is essential so that signs of complications are promptly treated. Once a person with diabetes begins walking again after bunion surgery, calluses can develop on the bottom of the foot. Calluses can crack and bleed, serving as a portal for infection into the foot.
Avoiding Recurrence
To keep a bunion from recurring, make sure your shoes fit properly. Crowding toes into too-small shoes can cause not only bunions but small cuts from toenails digging into other toes, which can lead to infection. Since a person with diabetes may not have good feeling in her feet, she may not realize she has an injury until it becomes severe. In addition to checking shoes for size, check the inside linings for rough spots that might irritate skin.
