You may wonder what diabetes has to do with the feet. The answer is…everything! There are many complications of diabetes that end up affecting the feet. They, unfortunately, also put the feet at risk. This is why you may hear about people with diabetes having toes or parts of their feet amputated. That’s why my mission is to help every person with diabetes keep their feet. If you're worried about a diabetic foot problem, stop reading and contact our office immediately!
Diabetes is a disease where insulin is not produced. This leads to an excessive amount of sugar in the bloodstream. The sugar circulating in the bloodstream causes health problems. If this goes on for a long time, it can affect the feet. According to the American Diabetes Association, over 10% of the US population has diabetes. Diabetes complications causes more than 50% of foot amputations in the United States.
Why are Diabetics Prone to Foot Problems?
People with diabetes have certain metabolic changes that occur. These include:
- Peripheral Neuropathy
- Peripheral Arterial Disease
- Poor Immune System
These three issues are the precursors to a host of problems involving the foot and ankle. Don’t worry, we’ll discuss each of these in detail.
When sugar levels are uncontrolled for an extended period of time, you can have nerve damage. This nerve damage, called Diabetic neuropathy, can present in one of two ways. It can be painful, feeling as if your feet are on fire. It can also cause your feet to feel numb.
Peripheral Neuropathy in diabetics is particularly dangerous. If your feet are numb and you step on something, you may not know that there is something embedded in your foot. This can lead to an open cut. It can become infected. The infection can spread to the bone. If not treated, this can lead to an amputation being necessary.
Peripheral Arterial Disease (PAD)
Diabetes can affect the blood flow to your feet. Without good blood flow, it makes it very difficult for your feet to heal from any cut or wound. If you have an infection that is not healing due to poor blood flow, it can become gangrenous. This can lead to amputation.\
Diabetes is a major risk factor for PAD. Another controllable risk factor is smoking. Smoking causes the arteries to harden and further restricts your blood flow. Diabetes and smoking are a deadly combination!
Some people feel pain in their legs when they walk distances. This is called intermittent claudication. The pain is because the lack of circulation. Poor blood flow does not allow the muscles to get the oxygen they need to function. If you stop and rest for a short time, you should be able to walk again without pain. Eventually the pattern will repeat itself. If you find that this is happening, it is essential that you come in for a visit. You can also schedule a visit with your internist, cardiologist, or endocrinologist.
And stop smoking!!
Poor Immune System
Diabetes comes along with a compromised immune system. Because of this, you have the potential to develop infections easier. It makes infections harder to treat. It generally impacts your ability to heal. That’s why we do so much to avoid complications from diabetes. Once you’ve developed a problem, it is very hard for them to resolve.
Why Diabetic Foot Care is Important
Regular Diabetic Foot Care is essential. It ensures that you don’t develop any complications from diabetes in your feet. I recommend that diabetics with few risk factors to come visit our Houston podiatry office twice a year. At those visits we will perform a comprehensive evaluation. For people with more risk factors, we’ll see them more often.
Relying on visiting our office isn’t enough. You need to take control of your diabetic foot care between visits. Follow these guidelines to care for your feet at home:
- Inspect your feet daily – You are looking for cuts, blisters, redness, or pus. Essentially you want to find anything that wasn’t there yesterday. If you notice something, call the office and say, “I’m diabetic and I think I have a problem” and we’ll get you in right away.
- Soak your feet in lukewarm water – You may have some nerve damage from diabetes. Because of this, it is important to never soak your feet in hot water. Like you would for a baby, test the water with your elbow.
- Wash and dry your feet well – Be sure to wash your feet and between your toes. It is important to make sure you dry them well too. This will prevent athlete’s foot forming. If a towel isn’t cutting it, you may want to use a hair dryer on the cool setting.
- Moisturize Your Feet, but not between your toes – It’s important to keep your feet moisturized to keep the skin healthy. Avoid applying cream between your toes, which can
- Cut your nails carefully – You should cut your toenails straight across and file the corners. If you think you’re developing an ingrown toenail, come in to see us. Do not do bathroom surgery!
- Don’t treat corns or calluses with medicated pads – Medicated pads have acid that can burn through the skin and cause an ulcer to form
- Never walk barefoot – Because your feet may be numb, you won’t know if you step on something that stays in your foot. This can cause an infection and can put your feet at risk. Always protect your feet.
What Causes a Diabetic Foot Ulcer?
A diabetic foot ulcer is a hole in the foot. It can involve the skin alone. Often, the ulcer reaches the tendons and bone. It can become infected. It can lead to a bone infection called osteomyelitis. It can ultimately require an amputation. It is better to prevent a diabetic foot ulcer than to treat one.
A diabetic foot ulcer forms in an area of high pressure. Often these are beneath the metatarsal bones in the ball of the foot. The pressure beneath the bone can cause a callus to form. Because of diabetic neuropathy, you won’t feel pain from the callus. Ultimately, your body won’t be able to manage this pressure and the skin will start to break down.
If you ignore a diabetic foot ulcer, it won’t go away. In fact, it will get worse. It will get larger and deeper. It will become infected and cause the bone to become infected. It can lead to gangrene which will need an amputation. So, no, don’t ignore a diabetic foot ulcer. You can lose your limb and possibly your life.
There are many ways to heal a diabetic foot ulcer. There are many types of dressings that are available. There are skin substitutes for wounds that don’t heal right away. We also have to take away the pressure that caused the wound in the first place.
A diabetic foot ulcer is a medical emergency. It is essential that you call our office immediately and say, “I’m diabetic and I think I have a foot ulcer." We will get you in right away. The sooner we treat your diabetic foot ulcer, the best chance we have to heal it successfully.
Put Your Diabetic Feet in Houston Podiatrist Dr. Andrew Schneider’s Hands
You can prevent these terrible diabetic foot complications. You need to establish a good relationship with a podiatrist. Dr. Andrew Schneider sees diabetic patients every day. Most, fortunately, are healthy with no foot problems. But they understand the importance of routine visits.
Some of my diabetic patients come to see me weekly for care in healing a diabetic foot ulcer. Yes, weekly. That’s my commitment to you to ensure your diabetic foot ulcer heals without it turning the wrong way.
If you are diabetic contact Houston podiatrist Dr. Andrew Schneider. Whether you have a current problem or not. We will work together to prevent diabetic foot problems from occurring.