The
Diabetic Foot
Foot care
amongst diabetics is incredibly important. Even small
ulcers on the foot can represent a serious risk: they
may heal extremely slowly and need rigorous treatment
to cure. Foot ulcers affect as many as 1 out of every
10 diabetes sufferers, during the entirety of their
condition. Ulcers can develop into serious lower body
infections, with the possibility of amputation at
an advanced stage. However, caring for your feet as
a diabetic is not difficult, and it should be a prime
consideration.
The
foot is especially affected by diabetes because:
-
diabetes
damages the nerves (damage can occur to the foot
and not be detected) - this is called peripheral
neuropathy.
-
diabetes
also affect the circulation. Poor circulation
can affect the ability of the body to heal when
damage occurs.
-
those
with diabetes are more prone to infection - the
body's processes that normally fight infection
respond slower and often have trouble getting
to infections due to the poor circulation.
-
diabetes
can also affect the joints, making them stiffer
-
other
diabetes complications that can also affect the
foot, for example, kidney disease (affects proteins
that are involved in wound healing) and eye disease
(can't see the foot to check for damage).
Why should
I be so careful?
The presence
of high blood glucose levels over a long period of
time may result in damage to the body and to bodily
functions. Although it is uncertain how this process
works, amongst diabetics it is relatively frequent.
A condition called diabetic neuropathy sometimes occurs
over time. Commonly, this manifests itself as peripheral
neuropathy, and usually affects the sensory nerves
in the legs. If your nervous system is even slightly
damaged, the extremities of the body can become numb.
For this reason, you may not be able to feel foot
problems until they have developed. Furthermore, normal
skin lubrication may be impaired and the feet may
become dry and cracked. Pressure from walking and
running may go unfelt, whilst developing into serious
problems. Complications may develop into neuropathic
ulcers, which are typified by the following factors:
- Little
or disproportionate pain
- Location
at the centre of a ring of calluses
- Located
under the feet and at the tips of the toes
To make
matters more complicated, because the immune system
may be damaged or not functioning correctly, these
impediments may take longer to heal. Infections may
quickly spread and become gangrenous.
Foot care
tips for diabetics
There are
a number of healthcare tips that should be adhered
to in order to make sure your feet stay as healthy
as possible:
- Examine
your feet yourself
Feet are
somewhat like teeth. It is easy to ignore mild problems
with them, hoping that they will go away. However,
the best course of action is to regularly examine
your own feet for the slightest sign of ulcers or
problems. This can be particularly important if you
are suffering from poor circulation and numbness.
Treat any cut, graze, bruise or mark with suspicion:
either treat it yourself or consult your doctor as
soon as possible. Also be aware of cracking from dry
skin becoming ulcerated over time. Take extreme care
of your feet, making sure that your socks and footwear
are comfortable and fit well. If your eyesight has
diminished due to diabetes, make sure that a professional
is on hand to examine your feet and cut your nails.
- Have
your feet examined by a professional
Making
sure that you receive a regular check-up from a health
professional is also a good idea. In this way, any
problems will be detected at an early stage, and treatment
should be relatively simple and painless.
- Manage
your diabetes
Strictly
controlling your diabetes with an aggressive treatment
regime, healthy diet and lifestyle, and an appropriate
amount of exercise means that you are less likely
to suffer from foot complications, such as foot ulcers.
How are
diabetic foot ulcers treated?
Diabetic
foot ulcers are treated depending upon their severity.
The first stage will be to remove any factors that
are exerting pressure on sensitive areas of the foot.
This could include footwear such as shoes or socks.
Several companies make specific products for the diabetic
foot. Calluses must be removed regularly by a podiatrist
or other specialist. The wound should be cleaned and
dressed, protected by the bandage but allowed to breathe.
In more severe cases, it may be necessary to wear
an orthowedge: a special shoe designed to alleviate
pressure on the front of the foot. Further treatment
may include the application of a contact cast, heavily
padded inside to reduce pressure on the foot.
What is
Charcot's arthropathy?
Diabetic
neuropathy may become further complicated by Charcot's
arthropathy. This severe complication may affect both
type 1 and type 2 diabetics, and occurs when diabetic
neuropathy goes unnoticed. Within the foot, unnoticed
pressure causes weakening of the bones and internal
fractures. In worst cases this can lead to terminal
ulceration, and the need for amputation. Charcot's
is hard to spot at first; its only symptoms are swelling.
The pain felt by the sufferer may be totally disproportionate
to the injury.
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