If you have diabetes, your blood sugar levels are too high. Over time, this can damage your nerves or blood vessels. Nerve damage from diabetes can cause you to lose feeling in your feet. You may not feel a cut, a blister or a sore. Foot injuries such as these can cause ulcers and infections. Serious cases may even lead to amputation. Damage to the blood vessels can also mean that your feet do not get enough blood and oxygen. It is harder for your foot to heal, if you do get a sore or infection.
Diabetes also accelerates macrovascular disease, which is evident clinically as accelerating atherosclerosis and/or peripheral vascular disease. Most diabetic foot infections occur in the setting of good dorsalis pedis pulses; this finding indicates that the primary problem in diabetic foot infections is microvascular compromise. Impaired microvascular circulation hinders white cell migration into the area of infection and limits the ability of antibiotics to reach the site of infection in an effective concentration. Diabetic neuropathy may be encountered in conjunction with vasculopathy.
Foot problems are a big risk. Like all diabetic people, you should monitor your feet. If you don’t, the consequences can be severe, including amputation, or worse. Minor injuries become major emergencies before you know it. With a diabetic foot, a wound as small as a blister from wearing a shoe that’s too tight can cause a lot of damage. Diabetes decreases your blood flow, so your injuries are slow to heal. When your wound is not healing, it’s at risk for infection. As a diabetic, your infections spread quickly.
Type 1 diabetes, formerly called juvenile diabetes, is an autoimmune disease in which the immune system destroys insulin-producing cells in the pancreas. Type 1 diabetes occurs most often in children and young adults, but it can develop at any age. Because their bodies do not produce it, patients with this type must take insulin daily to regulate blood sugar levels.
Type II: Any Type I symptom, plus: unexplained weight gain, pain, cramping, tingling or numbness in your feet, unusual drowsiness, frequent vaginal or skin infections, dry, itchy skin and slow healing sores.
The diabetic may not properly perceive minor injuries (such as cuts, scrapes, blisters), signs of abnormal wear and tear (that turn into calluses and corns), and foot strain. Normally, people can feel if there is a stone in their shoe and remove it immediately. A diabetic may not be able to perceive a stone. Its constant rubbing can easily create a sore.
In patients with diabetes, superficial skin infections such as cellulitis are caused by the same organisms as those in healthy hosts, namely group A streptococci and S aureus. However, in unusual epidemiologic circumstances, organisms such as Pasteurella multocida (eg, from dog or cat bites or scratches) may be noted and should always be considered.
Treatment for foot sores or ulcers that do not heal properly due to poor circulation may involve a vessel bypass. Blocked blood vessels (i.e., atherosclerosis) can be bypassed with a blood vessel graft. Improved circulation promotes healing.
Examine your feet daily and also after any trauma, no matter how minor, to your feet. Report any abnormalities to your physician. Use a water-based moisturizer every day (but not between your toes) to prevent dry skin and cracking. Wear cotton or wool socks. Avoid elastic socks and hosiery because they may impair circulation.
Make an appointment with a podiatrist to treat foot problems or to have corns or calluses removed. Never attempt to treat these yourself using over-the-counter remedies. If obesity prevents you from being physically able to inspect your feet, ask a family member, neighbor, or a visiting nurse to perform this important check.