Foot problems plague diabetics. Diabetes is the No. 1 cause of lower extremity amputations, according to a 1998 American Family Physician article titled "Diabetic Foot Ulcers: Prevention, Diagnosis and Classification" written by podiatrists David Lawrence and Lawrence Lavery. Twenty-five percent of all diabetic hospital admissions are due to foot ulcers. Diabetes damages both the small vessels that supply oxygen to the feet, and also the body's ability to fight off infections. Peripheral neuropathy, damage to the nerves, makes it difficult for the diabetic to tell when the foot is damaged.
Neuropathy
Peripheral neuropathy can cause numbness, pain or tingling in affected extremities, or may have no symptoms at all. Sixty to 70 percent of all diabetics have some form of neuropathy, especially those who have had diabetes for more than 25 years, the National Diabetes Information Clearinghouse states. Diabetics who smoke are more likely to have peripheral neuropathy, as are those who are overweight. Muscle wasting in the foot may occur, and reflexes in the foot may be lost, causing changes in the way the person walks and putting undue pressure on some areas of the foot.
Ulcers
Foot ulcers are common in diabetes, for several reasons. The lack of feeling allows small injuries to go unnoticed, and many diabetics put more pressure on some areas of the foot than others, due to this lack of feeling. This makes corns and calluses that break down into ulcerations from uneven pressure on the foot more likely. Around 15 to 20 percent of diabetics will develop a lower extremity ulcer at some time; of those, 15 percent will require amputation, the University of Nevada School of Medicine states. Frequent inspection of the feet and treatment of corns and calluses by a podiatrist helps decrease the risk of ulceration.
Infections
Open wounds on the foot like ulcers, athlete's foot between the toes and ingrown toenails often lead to infection. Infection is more common in diabetes because the high glucose content in blood encourages the growth of bacteria, and because the wound may not be noticed when it's small and manageable due to neuropathy. Foot infections can develop gangrene, or tissue death, leading to amputation. Osteomyelitis, or bone infection, may occur. Debridement and antibiotics are used to treat infections.
