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Diabetic Foot Problems

By Deborah Fields, BSc (Hons), PgDip, MCIPR

Diabetes is a condition that results in high blood sugar (glucose) in a patient because the body is not making enough of the hormone insulin, which helps break down the sugar entering the cells and create fuel for its functions.

Globally, about 9% of the population over the age of 18 have diabetes. It most commonly affects people in the low and middle income levels.

Cuts and grazes on the feet of a diabetic can be dangerous. If the blood sugar is high, it can affect circulation in the body.

The first place in the body that this affects is the feet. Diabetics have to look out for the warning signs of poor circulation such as the feet being warm, red, and swelling up.

In diabetics, even a small cut or a blister on the foot can develop into an infection or foot ulcer.

The patient may not have felt the cut or sensed the blister because he or she has lost sensation in their feet because of neuropathy due to the high blood sugar.

Any such cut will need to be treated by a medical professional. The patient may have to take antibiotics, cover the wound with dressing, and rest.

A diabetic is at a high risk of injury deforming their foot or leading, in extreme cases, to an amputation if it is not attended to as soon as possible.

How Does High Blood Sugar Affect Circulation?

High levels of glucose in the blood can lead to nerve damage, known as neuropathy in the body and poor circulation.

When circulation is affected, the blood does not move around the body as well as it should. Cuts and grazes will not heal easily and the patient may experience cramps and pain in the legs.

Atherosclerosis, an inflammatory disease that causes thickening of the blood vessels, is likely to develop.

Neuropathy can be expressed in several ways.

Sensory Neuropathy

Sensory neuropathy is the most common type of nerve damage and impacts the nerves that carry information around the body from the bones, skin, and muscles to the brain.

It also affects how we feel temperature and pain. When a diabetic does not feel a cut or graze on their feet, it is likely that they are experiencing sensory neuropathy.

Motor Neuropathy

This damages the nerves that send information about movement. It can affect the feet by changing their shape, altering the arch, and causing toes to claw. There is also the risk of fractures in the bones.

Autonomic Neuropathy

This affects functions in the body that happen automatically such as sweating and can lead to dry skin from reduced moisture.

As a result, diabetics have to be very vigilant about any changes they experience in their feet or any sensations or lack of feeling in parts of the body as a result of their condition.

How Can Diabetics Care for their Feet?

It is important for diabetics to take good care of their feet so that they minimize any risk of cutting their feet or causing blisters. Corns - thickened areas on the skin caused by rubbing; calluses - dry, hard skin around the heel; as well as bunions - deformities on the big toe and bunionettes on the little toe are all risks for the diabetic. They need to be particularly careful that their shoes fit well and do not rub their feet.

Diabetics need to be alert about their feet and see a podiatrist to attend to any changes such as a new corn on their toes.

On a daily basis, diabetics should also try to maintain a good moisture level in their feet as they tend to become very dry.

Petroleum jelly is ideal for this purpose. Diabetics should also avoid smoking because as it can worsen circulation and make wounds take longer to heal.

Sometimes diabetic patients use specially designed shoes which help protect them from injuries. Walking bare foot is not advised in case of diabetics because of the increased risk of cuts or bruises.

Reviewed by Susha Cheriyedath, MSc

References

Further Reading

Last Updated: Jun 2, 2016

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