Type 2 Diabetes And Your Feet
For people with diabetes, foot complications such as neuropathy and circulation problems can make it difficult for wounds to heal. Serious problems can arise from common skin issues such as: sores cuts ulcers Diabetes that is not well controlled can lead to slower healing. These slow-to-heal wounds can lead to infections. Other foot issues, such as calluses, are also common in people with diabetes. While calluses may not seem worrisome, if left untrimmed they can turn into ulcers or open sores. People with diabetes are also at risk for Charcot joint, a condition in which a weight-bearing joint progressively degenerates, leading to bone loss and deformity. Because of nerve damage, people with diabetes may not immediately notice that there are problems with their feet. Over time, people with diabetic neuropathy can develop foot problems that cannot be healed, which can lead to amputations. Diabetes is one of the leading causes of lower-extremity amputations in the United States. Uncontrolled high blood sugar levels in people with poorly controlled diabetes can cause peripheral neuropathy, the medical term for numbness and loss of sensation due to damage to the nerves that serve the feet and hands. People with diabetic neuropathy cannot feel various sensations, such as pressure or touch, as intensely as those without damage to their nerves. On the other hand, peripheral neuropathy is often very painful, causing burning, tingling, or other painful feelings in the feet. If a wound is not felt right away, it can go unchecked. Poor circulation can make it difficult for the body to heal these wounds. Infection can then set in and become so serious that amputation becomes necessary. Checking the feet for abnormalities is a very important part of diabetes care. Abnormalities may Continue reading >>
Diabetic Neuropathy
Print Overview Diabetic neuropathy is a type of nerve damage that can occur if you have diabetes. High blood sugar (glucose) can injure nerve fibers throughout your body, but diabetic neuropathy most often damages nerves in your legs and feet. Depending on the affected nerves, symptoms of diabetic neuropathy can range from pain and numbness in your extremities to problems with your digestive system, urinary tract, blood vessels and heart. For some people, these symptoms are mild; for others, diabetic neuropathy can be painful, disabling and even fatal. Diabetic neuropathy is a common serious complication of diabetes. Yet you can often prevent diabetic neuropathy or slow its progress with tight blood sugar control and a healthy lifestyle. Symptoms There are four main types of diabetic neuropathy. You may have just one type or symptoms of several types. Most develop gradually, and you may not notice problems until considerable damage has occurred. The signs and symptoms of diabetic neuropathy vary, depending on the type of neuropathy and which nerves are affected. Peripheral neuropathy Peripheral neuropathy is the most common form of diabetic neuropathy. Your feet and legs are often affected first, followed by your hands and arms. Signs and symptoms of peripheral neuropathy are often worse at night, and may include: Numbness or reduced ability to feel pain or temperature changes A tingling or burning sensation Sharp pains or cramps Increased sensitivity to touch — for some people, even the weight of a bed sheet can be agonizing Muscle weakness Loss of reflexes, especially in the ankle Loss of balance and coordination Serious foot problems, such as ulcers, infections, deformities, and bone and joint pain Autonomic neuropathy The autonomic nervous system controls your hea Continue reading >>
Diabetic Foot Care Article
A A A Diabetes mellitus (DM) represents several diseases in which high blood glucose levels over time can damage the nerves, kidneys, eyes, and blood vessels. Diabetes can also decrease the body's ability to fight infection. When diabetes is not well controlled, damage to the organs and impairment of the immune system is likely. Foot problems commonly develop in people with diabetes and can quickly become serious. With damage to the nervous system, a person with diabetes may not be able to feel his or her feet properly. Normal sweat secretion and oil production that lubricates the skin of the foot is impaired. These factors together can lead to abnormal pressure on the skin, bones, and joints of the foot during walking and can lead to breakdown of the skin of the foot. Sores may develop. Damage to blood vessels and impairment of the immune system from diabetes make it difficult to heal these wounds. Bacterial infection of the skin, connective tissues, muscles, and bones can then occur. These infections can develop into gangrene. Because of the poor blood flow, antibiotics cannot get to the site of the infection easily. Often, the only treatment for this is amputation of the foot or leg. If the infection spreads to the bloodstream, this process can be life-threatening. People with diabetes must be fully aware of how to prevent foot problems before they occur, to recognize problems early, and to seek the right treatment when problems do occur. Although treatment for diabetic foot problems has improved, prevention - including good control of blood sugar level - remains the best way to prevent diabetic complications. People with diabetes should learn how to examine their own feet and how to recognize the early signs and symptoms of diabetic foot problems. They should also l Continue reading >>
Diabetes Foot Care Guidelines
Diabetes can be dangerous to your feet—even a small cut can produce serious consequences. Diabetes may cause nerve damage that takes away the feeling in your feet. Diabetes may also reduce blood flow to the feet, making it harder to heal an injury or resist infection. Because of these problems, you may not notice a foreign object in your shoe. As a result, you could develop a blister or a sore. This could lead to an infection or a nonhealing wound that could put you at risk for an amputation. To avoid serious foot problems that could result in losing a toe, foot or leg, follow these guidelines. Inspect your feet daily. Check for cuts, blisters, redness, swelling or nail problems. Use a magnifying hand mirror to look at the bottom of your feet. Call your doctor if you notice anything. Bathe feet in lukewarm, never hot, water. Keep your feet clean by washing them daily. Use only lukewarm water—the temperature you would use on a newborn baby. Be gentle when bathing your feet. Wash them using a soft washcloth or sponge. Dry by blotting or patting and carefully dry between the toes. Moisturize your feet but not between your toes. Use a moisturizer daily to keep dry skin from itching or cracking. But don't moisturize between the toes—that could encourage a fungal infection. Cut nails carefully. Cut them straight across and file the edges. Don’t cut nails too short, as this could lead to ingrown toenails. If you have concerns about your nails, consult your doctor. Never treat corns or calluses yourself. No “bathroom surgery” or medicated pads. Visit your doctor for appropriate treatment. Wear clean, dry socks. Change them daily. Consider socks made specifically for patients living with diabetes. These socks have extra cushioning, do not have elastic tops, are highe Continue reading >>
Tips For Treating Diabetic Nerve Pain
Diabetes can cause long-term problems throughout your body, especially if you don’t control your blood sugar effectively, and sugar levels remain high for many years. High blood sugar can cause diabetic neuropathy, which damages the nerves that send signals from your hands and feet. Diabetic neuropathy can cause numbness or tingling in your fingers, toes, hands, and feet. Another symptom is a burning, sharp, or aching pain (diabetic nerve pain). The pain may be mild at first, but it can get worse over time and spread up your legs or arms. Walking can be painful, and even the softest touch can feel unbearable. Up to 50 percent of people with diabetes may experience nerve pain. Nerve damage can affect your ability to sleep, decrease your quality of life, and can also cause depression. Damaged nerves can’t be replaced. However, there are ways that you can prevent further damage and relieve your pain. First, control your blood sugar so the damage doesn’t progress. Talk to your doctor about setting your blood sugar goal, and learn to monitor it. You may be asked to lower your blood sugar before meals to 70 to 130 milligrams per deciliter (mg/dL) and your blood sugar after meals to less than 180 mg/dL. Use diets, exercise, and medications to decrease your blood sugar to a healthier range. Monitor other health risks that can worsen your diabetes, such as your weight and smoking. Ask your doctor about effective ways to lose weight or quit smoking, if necessary. Your doctor might suggest trying an over-the-counter pain reliever, such as acetaminophen (Tylenol), aspirin (Bufferin), or ibuprofen (Motrin IB, Advil), which are available without a prescription but can cause side effects. Use a low dose for a short time to control your symptoms. Other options exist for stronger Continue reading >>
Diabetes And Foot Problems
For people with diabetes, having too much glucose (sugar) in their blood for a long time can cause some serious complications, including foot problems. you might like Diabetes can cause two problems that can affect your feet: Diabetic neuropathy. Uncontrolled diabetes can damage your nerves. If you have damaged nerves in your legs and feet, you might not feel heat, cold, or pain. This lack of feeling is called "sensory diabetic neuropathy." If you do not feel a cut or sore on your foot because of neuropathy, the cut could get worse and become infected. The muscles of the foot may not function properly, because the nerves that make the muscles work are damaged. This could cause the foot to not align properly and create too much pressure in one area of the foot. It is estimated that up to 10% of people with diabetes will develop foot ulcers. Foot ulcers occur because of nerve damage and peripheral vascular disease. Peripheral vascular disease. Diabetes also affects the flow of blood. Without good blood flow, it takes longer for a sore or cut to heal. Poor blood flow in the arms and legs is called "peripheral vascular disease." Peripheral vascular disease is a circulation disorder that affects blood vessels away from the heart. If you have an infection that will not heal because of poor blood flow, you are at risk for developing ulcers or gangrene (the death of tissue due to a lack of blood). Continue reading >>
Diabetes And Foot Problems Treatment And Complications
Diabetes and foot problems facts Two main conditions, peripheral artery disease (PAD) and peripheral neuropathy, are responsible for the increased risk of foot problems in people with diabetes. Symptoms and signs of diabetic foot problems arise due to the decreased sensation from nerve damage as well as the lack of oxygen delivery to the feet caused by vascular disease. Diabetic foot problems also include bunions, corns, calluses, hammertoes, fungal infections, dryness of the skin, and ingrown toenails. These problems are not specific to diabetes, but may occur more commonly due to the nerve and vascular damage caused by diabetes. Treatment depends on the exact type of foot problem. Surgery or even amputation may be required for some cases. Gangrene (dry gangrene) is tissue death due to absence of blood circulation. It can be life threatening if bacterial infection develops (wet gangrene). Many diabetes-related foot problems can be prevented by good control of blood sugar levels combined with appropriate care of the feet. How can diabetes cause foot problems? Both type 1 and type 2 diabetes cause damage to blood vessels and peripheral nerves that can result in problems in the legs and feet. Two main conditions, 1) peripheral artery disease (PAD), and 2) peripheral neuropathy are responsible for the increased risk of foot problems in people with diabetes. Peripheral artery disease (PAD), sometimes referred to as peripheral vascular disease (PVD), means that there is narrowing or occlusion by atherosclerotic plaques of arteries outside of the heart and brain. This is sometimes referred to as "hardening" of the arteries. Diabetes is a known risk factor for developing peripheral artery disease. In addition to pain in the calves during exercise (medically known as intermitte Continue reading >>
Diabetic Foot Problems
What foot problems can be caused by diabetes? Diabetes mellitus can cause serious foot problems. These conditions include diabetic neuropathy (loss of normal nerve function) and peripheral vascular disease (loss of normal circulation). These two conditions can lead to: Diabetic foot ulcers: wounds that do not heal or become infected Infections: skin infections (cellulitis), bone infections (osteomyelitis) and pus collections (abscesses) Gangrene: dead tissue resulting from complete loss of circulation Charcot arthropathy: fractures and dislocations that may result in severe deformities Amputation: partial foot, whole foot or below-knee amputation What are the symptoms of a diabetic foot problem? Symptoms of neuropathy may include the loss of protective sensation or pain and tingling sensations. Patients may develop a blister, abrasion or wound but may not feel any pain. Decreased circulation may cause skin discoloration, skin temperature changes or pain. Depending on the specific problem that develops, patients may notice swelling, discoloration (red, blue, gray or white skin), red streaks, increased warmth or coolness, injury with no or minimal pain, a wound with or without drainage, staining on socks, tingling pain or deformity. Patients with infection may have fever, chills, shakes, redness, drainage, loss of blood sugar control or shock (unstable blood pressure, confusion and delirium). How do some of these complications develop? Neuropathy is associated with the metabolic abnormalities of diabetes. Vascular disease is present in many patients at the time of diagnosis of diabetes. Ulcers may be caused by external pressure or rubbing from a poorly fitting shoe, an injury from walking barefoot, or a foreign object in the shoe (rough seam, stone or tack). Infecti Continue reading >>
Diabetes And Foot Problems
Foot problems are common in people with diabetes. You might be afraid you’ll lose a toe, foot, or leg to diabetes, or know someone who has, but you can lower your chances of having diabetes-related foot problems by taking care of your feet every day. Managing your blood glucose levels, also called blood sugar, can also help keep your feet healthy. How can diabetes affect my feet? Over time, diabetes may cause nerve damage, also called diabetic neuropathy, that can cause tingling and pain, and can make you lose feeling in your feet. When you lose feeling in your feet, you may not feel a pebble inside your sock or a blister on your foot, which can lead to cuts and sores. Cuts and sores can become infected. Diabetes also can lower the amount of blood flow in your feet. Not having enough blood flowing to your legs and feet can make it hard for a sore or an infection to heal. Sometimes, a bad infection never heals. The infection might lead to gangrene. Gangrene and foot ulcers that do not get better with treatment can lead to an amputation of your toe, foot, or part of your leg. A surgeon may perform an amputation to prevent a bad infection from spreading to the rest of your body, and to save your life. Good foot care is very important to prevent serious infections and gangrene. Although rare, nerve damage from diabetes can lead to changes in the shape of your feet, such as Charcot’s foot. Charcot’s foot may start with redness, warmth, and swelling. Later, bones in your feet and toes can shift or break, which can cause your feet to have an odd shape, such as a “rocker bottom.” What can I do to keep my feet healthy? Work with your health care team to make a diabetes self-care plan, which is an action plan for how you will manage your diabetes. Your plan should inclu Continue reading >>
Diabetic Foot Pain And Ulcers: Causes And Treatment
Foot ulcers are a common complication of poorly controlled diabetes, forming as a result of skin tissue breaking down and exposing the layers underneath. They’re most common under your big toes and the balls of your feet, and they can affect your feet down to the bones. All people with diabetes can develop foot ulcers and foot pain, but good foot care can help prevent them. Treatment for diabetic foot ulcers and foot pain varies depending on their causes. Discuss any foot pain or discomfort with your doctor to ensure it’s not a serious problem, as infected ulcers can result in amputation if neglected. One of the first signs of a foot ulcer is drainage from your foot that might stain your socks or leak out in your shoe. Unusual swelling, irritation, redness, and odors from one or both feet are also common early symptoms of a foot ulcer. The most visible sign of a serious foot ulcer is black tissue (called eschar) surrounding the ulcer. This forms because of an absence of healthy blood flow to the area around the ulcer. Partial or complete gangrene, which refers to tissue death due to infections, can appear around the ulcer. In this case, odorous discharge, pain, and numbness can occur. Signs of foot ulcers are not always obvious. Sometimes, you won’t even show symptoms of ulcers until the ulcer has become infected. Talk to your doctor if you begin to see any skin discoloration, especially tissue that has turned black, or feel any pain around an area that appears callused or irritated. Your doctor will likely identify the seriousness of your ulcer on a scale of 0 to 3 using the following criteria: 0: no ulcer but foot at risk 1: ulcer present but no infection 2: ulcer deep, exposing joints and tendons 3: extensive ulcers or abscesses from infection Diabetic ulcers a Continue reading >>
Diabetic Foot Pain
by Kenneth B. Rehm, DPM Includes photo of Dr. Kenneth B. Rehm, DPM Diabetes is one of the most common reasons people seek relief for painful feet. With diabetes, four types of foot problems may arise in the feet. Nerve Problems due to Diabetes The most common contributor to diabetic foot pain is a nerve problem called Peripheral Neuropathy. This is where the nerves are directly affected by the disease process. There are basically three types of peripheral neuropathy: sensory, motor, and autonomic neuropathy. A large percentage of pain diabetic patients complain of is due to sensory neuropathy. This can show up as "sensitive pain," where the amount of pain is not proportional to the amount of insult that is causing it. For instance, just touching the skin or putting a sheet over your feet in bed could be painful. This can be present at the same time as numbness in the feet. Sensory neuropathy symptoms can include burning, tingling or a stabbing pain. Relief is foremost on someone's mind when painful neuropathy has raised its ugly head. The first thing to do is to check your blood sugar for the past several weeks to see if there has been a trend toward high blood sugar (Editor's Note: The A1c test is traditionally employed to determine this, and should be repeated about every three months.) Persistent high blood sugar can contribute to this type of pain. Massaging your feet with a diabetic foot cream, or using a foot roller, often takes the edge off the pain. Vitamin B preparations are often recommended; and there are a variety of prescription medications that do work. Using cushioned, supportive shoes and foot support inserts is always needed to protect the feet from the pounding, rubbing and irritating pressures that contribute to neuropathic pain. Motor neuropathy can Continue reading >>
Common Foot Problems And Their Solutions
People with diabetes are often told to pay close attention to their feet – and for good reason. While having diabetes doesn’t make it more likely that you’ll injure your feet in the first place, having certain common diabetes complications raises the risk of minor foot problems becoming major foot problems if not treated promptly. One of those complications is peripheral neuropathy, or damage to the nerves in the feet and lower legs. Peripheral neuropathy can cause a loss of sensation in the feet, meaning that heat, cold, and/or pain may not be felt. As a result, a person becomes more vulnerable to getting burned if he steps into hot water or walks barefoot on hot pavement or sand, and he’s also more likely to let small blisters, cuts, and scrapes on his feet go untreated since he doesn’t feel them. The other common diabetes-related complication that raises the risk of foot problems is reduced blood circulation to the feet. Blood carries oxygen and other nutrients and substances that are necessary for wound healing. When blood circulation is reduced, wounds heal more slowly and have more time to become infected. The good news is that many if not most major foot problems are avoidable. How to do it? Maintain the best blood glucose and blood pressure control possible. Wear well-fitting shoes or slippers at all times (except for sleeping or bathing), and check inside them for foreign objects before putting them on. Check the tops and bottoms of your feet and between your toes every day, especially if you know or suspect you have either neuropathy or reduced blood circulation. Look or feel for any signs of rubbing, injury, or infection, such as redness, broken skin, or areas of unusual warmth. If you develop a foot problem, attend to it immediately. Apply first-ai Continue reading >>
How Can Diabetes Affect My Feet?
Chronically high blood sugar (glucose) levels can be associated with serious complications in people who have diabetes. The feet are especially at risk. Two conditions called diabetic neuropathy and peripheral vascular disease can damage the feet (and other areas of the body) in people who have diabetes. What is diabetic neuropathy? Chronically high sugar levels associated with uncontrolled diabetes can cause nerve damage that interferes with the ability to sense pain and temperature. This so-called "sensory diabetic neuropathy" increases the risk a person with diabetes will not notice problems with his or her feet. Nearly 10% of people with diabetes develop foot ulcers due to peripheral vascular disease and nerve damage. People with diabetes may not notice sores or cuts on the feet, which in turn can lead to an infection. Nerve damage can also affect the function of foot muscles, leading to improper alignment and injury. What is peripheral vascular disease? Diabetes is associated with poor circulation (blood flow). Inadequate blood flow increases the healing time for cuts and sores. Peripheral vascular disease refers to compromised blood flow in the arms and legs. Poor blood flow increases the risk that infections will not heal. This, in turn, increases the risk of ulcers and gangrene, which is tissue death that occurs in a localized area when there is an inadequate blood supply. What are common foot problems of people with diabetes? The following images show common foot problems that anyone can get; however, those with diabetes are at increased risk for serious complications associated with these conditions, including infection and even amputation. Athlete's foot Fungal infection of the feet is called athlete's foot. Cracked skin, itching, and redness are associated w Continue reading >>
How Can Diabetes Affect The Feet?
People with diabetes are prone to foot problems caused by prolonged periods of high blood sugar. There are two main foot problems, each of which can have serious complications. Diabetes is a disease where the body cannot produce insulin or cannot use it effectively. Insulin is the hormone that is responsible for helping the cells take in sugar to use for energy. When this does not happen properly, the levels of sugar in the blood can become too high. Prolonged periods of high sugar levels in the blood can wreak havoc on many areas of the body, including the feet. Diabetic foot problems The two main foot problems that affect people with diabetes are: Diabetic neuropathy Over time, diabetes can cause nerve damage that makes it hard for people with diabetes to feel sensation in their extremities. The condition also makes it difficult for a person to feel an irritation on their foot or notice when their shoes are rubbing. This lack of sensation and awareness leads to an increase in the risk of cuts, sores, and blisters developing. Peripheral vascular disease Diabetes leads to changes in the blood vessels, including arteries. In peripheral vascular disease, fatty deposits block these vessels beyond the brain and heart. It tends to affect the blood vessels leading to and from the extremities, reducing blood flow to the hands and feet. Reduced blood flow can lead to pain, infection, and slow healing wounds. Severe infections may lead to amputation. Symptoms Symptoms may vary from person to person and may depend on what issues a person is experiencing at the time. Symptoms of diabetic foot problems can include the following: loss of feeling numbness or tingling sensation blisters or other wounds without painful skin discoloration skin temperature changes red streaks wounds with Continue reading >>
How To Avoid Amputations If You Have Diabetes
In people with diabetes, a trifecta of trouble can set the stage for amputations: Numbness in the feet due to diabetic neuropathy (nerve damage) can make people less aware of injuries and foot ulcers. These ulcers may fail to heal, which can in turn lead to serious infections. "Normally a person with an injury on the bottom of their foot, such as a blister, will change the way they walk. Your gait will alter because you are going to protect that blistered spot until it heals up," says Joseph LeMaster, MD, an assistant professor at the University of Missouri–Columbia School of Medicine. "People with a loss of sensation don't do that. They will just walk right on top of that blister as though it wasn't there. It can burst, become infected, and turn into what we call a foot ulcer," he says. "That ulceration can go right down to the bone and become an avenue for infection into the whole foot. That's what leads to amputations." Foot injuries are the most common cause of hospitalizations About 15% of all diabetics will develop a foot ulcer at some point and up to 24% of people with a foot ulcer need an amputation. You're at extra-high risk if you're black, Hispanic, or Native American. These minority populations are two to three times more likely to have diabetes than non-Hispanic whites, and their rates of amputations are higher. "It's the most common reason that someone's going to be hospitalized with diabetesnot for high blood sugar or a heart attack or a stroke," says David G. Armstrong, DPM, a specialist in diabetic foot disease at Rosalind Franklin University of Medicine and Science in North Chicago. "It's for a hole in the foot, a wound." About a year ago, Dr. Armstrong treated a 59-year-old man with type 2 diabetes who had been working out at a local health club; 12 Continue reading >>
