How Does Diabetes Affect The Feet Specifically?
Long standing uncontrolled diabetes causes glycosylation of proteins throughout body,causing damage to blood vessels and nerves. Usually, manifestations occur after 10-12 years. Specifically, in relation to feet- It causes blood vessel damage- vasculopathy which impairs blood supply to nerves,damaging them which causes gradual loss of position sense,joint sense and pain sensation, So,patients are not able to sense trauma, which causes ulcers that go unnoticed, which is further infected by bacteria because of poor wound healing (decreased blood supply, weak immune system due to high blood levels and highly rich media for bacterial growth coz of high blood glucose). Coz,patients don't feel any pain,unless they regularly examine their feet,they can develop really big infected wounds causing death of tissue ( gangrene) and/or extension of infection in deeper tissues ( cellulitis,necrotising fascitis),bone(osteomyelitis) When limb or toes are dead and not salvageable, or there is threat to viability of proximal leg,or its causing threat to life of a patient, amputation is required along with extensive blood glucose control. Apart from this,many a times diabetic neuropathy can be very pa Continue reading >>