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 >>
Foot Care
When you have diabetes you need to take care of your feet every day Having diabetes can increase your risk of foot ulcers and amputations Daily care can prevent serious complications Check your feet daily for changes or problems Visit a podiatrist annually for a check up or more frequently if your feet are at high risk Your feet are at risk because diabetes can cause damage to the nerves in your feet, blood circulation and infection. Having diabetes can increase your risk of foot ulcers and amputations. This damage is more likely if: You have had diabetes for a long time Your blood glucose levels have been too high for an extended period You smoke – smoking causes a reduced blood flow to your feet, wounds heal slowly You are inactive. It's important to check your feet every day. If you see any of the following- get medical treatment that *day * Ulcer Unusual swelling Redness Blisters Ingrown nail Bruising or cuts If you see any of the following- get medical treatment within 7 days Broken skin between toes Callus Corn Foot shape changes Cracked skin Nail colour changes Poor blood glucose control can cause nerve damage to feet. Symptoms include: Numbness Coldness of the legs A tingling, pins and needles sensation in the feet Burning pains in the legs and feet, usually more noticeable in bed at night. These symptoms can result in a loss of sensation in the feet which increases the risk of accidental damage because you can’t feel any pain. An injury to the feet can develop into an ulcer on the bottom of a foot which can penetrate to the bone. This could lead to infection of the bone (osteomyelitis) and a chronic infection in the bones and joints. If an infection isn’t treated at the earliest signs, this could result in ulceration (an infected open sore) and eventually 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 >>
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 >>
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 >>
Diabetes: Protect Your Feet And Legs
If you have diabetes, you are more likely than people without this disorder to develop leg and foot problems. Diabetes can destroy nerves and cause you to have poor circulation. Left unchecked, these complications can lead to amputation. But there's a lot you can do to prevent that from happening. How Diabetes Causes Limb Problems First, it's important to understand what causes these diabetes complications. According to Marilyn Tan, MD, an endocrinologist and the clinic chief of the Stanford Endocrine Clinic in California, risk factors include poor circulation from atherosclerotic peripheral arterial disease, poor wound healing, and uncontrolled blood sugar increases, which increases the risk of infection. “Think of sugar as fuel for bacteria and fungus,” says Dr. Tan. Researchers also know that high blood glucose levels can cause nerve damage called diabetic neuropathy. The damage can occur in any part of your body, but it is most common in your arms and legs, with the lower extremities affected first. This type of nerve damage is known as peripheral neuropathy. Some people have no symptoms, while others experience numbness, tingling, burning, sharp pain, cramps, extreme sensitivity when touched, and a loss of coordination and balance. When you have peripheral neuropathy, small sores can go unnoticed because of the numbness — you simply don’t feel them. Left untreated, these little problems can become major infections that invade the bones. What’s more, poor circulation from diabetes means any ulcers and infections are harder to heal. If an infection invades your bones, then amputation could be required to save your life. “Diabetes is the leading cause of nontraumatic lower extremity (leg and foot) amputations in the United States,” says Tan. “Five perc 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: Foot & Skin Related Complications
How can diabetes affect feet and skin? For people with diabetes, having too much glucose (sugar) in their blood for a long time can cause some serious complications, including foot and skin problems, as well as heart disease, stroke, kidney disease, eye damage, and other problems. How can diabetes affect my feet? 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 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. 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. (The word "peripheral" means "located away from a central point," and the word "vascular" refers to the blood vessels. 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 gangrene, which is the death of tissue due to a lack of blood. To keep gangrene from spreading, the doctor may have to remove a toe, foot, or part of a leg. This procedure is called amputation. Diabetes is the most common, non-traumatic cause of leg amputations. Each year, more than 56,000 people with diabetes have amputations. However, research suggests that more than half of these amputations can be prevented through proper foot care. What are some common foot problems of people with diabetes? Anyone can get the foot problems listed below. For people Continue reading >>
If Only Toes Could Talk…
Bill came into my pharmacy several months ago, sat down, and took off his shoe and stocking to show me his toe. His middle toe was deep red and purple. He described how the strap of his sandal had rubbed a sore at the base of the toe, and said it was not painful. He asked about a solution to soak the foot in, or an antibiotic ointment to apply to the reddened area. I told him that for a person with diabetes, this is not a time to self-medicate and advised him to see his physician immediately to obtain proper treatment. His physician, after examining the ulcer and checking pulses in the ankle and foot, gave him a prescription for oral antibiotics. Your toes and feet can be a barometer of the current state of your diabetes control. Have you lost the hair on your toes? Are your toenails discolored and thickened? Is the skin on your legs shiny with dark patches? Are your feet cold at night? Do they change color on elevation? Have your feet developed a burning or tingling sensation? Do they hurt or are they without any feeling? Do you experience leg or foot cramps at night? As a person with diabetes, I am concerned about the health of my feet. I have seen too many preventable amputations of the toes, foot or lower limbs caused by Peripheral Vascular Disease (PVD). PVD means poor circulation and blood flow to the tissues in the foot. One sign of PVD may be loss of hair on the toes. Other signs such as cramping of the legs, or temperature changes in the foot may indicate PVD as well. Healing a foot ulcer can be difficult, expensive, and may take a long time. The patient with diabetes has difficulty fighting infection for many reasons, including impaired blood supply, nerve changes, and changes in the blood itself, such as white cell and platelet abnormalities. Healthy platelet Continue reading >>
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Everything You Should Know About Diabetic Blisters
If you have diabetes and experience the spontaneous eruption of blisters on your skin, they may well be diabetic blisters. These are also called bullosis diabeticorum or diabetic bullae. Although the blisters may be alarming when you first spot them, they’re painless and normally heal on their own without leaving scars. A number of skin conditions are associated with diabetes. Diabetic blisters are fairly rare. An article in the International Journal of Diabetes in Developing Countries notes that in the United States, the disorder occurs in only 0.5 percent of people with diabetes. Diabetic blisters are twice as likely to be found in men than in women. Diabetic blisters most often appear on your legs, feet, and toes. Less frequently, they show up on hands, fingers, and arms. Diabetic blisters can be as large as 6 inches, though they’re normally smaller. They’re often described as looking like blisters that occur when you get a burn, only without the pain. Diabetic blisters seldom appear as a single lesion. Rather, they are bilateral or occur in clusters. The skin surrounding the blisters isn’t normally red or swollen. If it is, see your doctor promptly. Diabetic blisters contain a clear, sterile fluid, and they’re usually itchy. Read about the eight best remedies for itching. Given the risk of infection and ulceration when you have diabetes, you may want to see a dermatologist to rule out more serious skin conditions. Diabetic blisters usually heal in two to five weeks without intervention, according to an article in Clinical Diabetes. The fluid in the blisters is sterile. To prevent infection, you shouldn’t puncture the blisters yourself, though if the lesion is large, your doctor may want to drain the fluid. This will keep the skin intact as a covering for Continue reading >>
What Can I Do For Numb, Painful Feet And Legs?
My husband was diagnosed with diabetes almost a year ago. At first he was experiencing numbness in his feet. Over the past few months, he began having pain as well, sometimes as far up his leg as his calf. What can we do to help these symptoms? I have read that vitamin E and even flaxseed oil are good for the circulation. Would those be helpful? 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 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: 12 Warning Signs That Appear On Your Skin
Diabetes can affect many parts of your body, including your skin. When diabetes affects the skin, it’s often a sign that your blood sugar (glucose) levels are too high. This could mean that: You have undiagnosed diabetes, or pre-diabetes Your treatment for diabetes needs to be adjusted If you notice any of the following warning signs on your skin, it’s time to talk with your doctor. This skin condition often begins as small raised solid bumps that look like pimples. As it progresses, these bumps turn into patches of swollen and hard skin. The patches can be yellow, reddish, or brown. You may also notice: The surrounding skin has a shiny porcelain-like appearance You can see blood vessels The skin is itchy and painful The skin disease goes through cycles where it is active, inactive, and then active again The medical name for this condition is necrobiosis lipodica (neck-row-by-oh-sis lee-poi-dee-ka). TAKE ACTION Get tested for diabetes if you have not been diagnosed. Work with your doctor to better control your diabetes. See a dermatologist about your skin. Necorbiosis lipodica is harmless, but it can lead to complications. A dark patch (or band) of velvety skin on the back of your neck, armpit, groin, or elsewhere could mean that you have too much insulin in your blood. AN is often a sign of prediabetes. The medical name for this skin condition is acanthosis nigricans (ay-can-THOE-sis NIE-gri-cans). TAKE ACTION: Get tested for diabetes. 3. Hard, thickening skin When this develops on the fingers, toes, or both, the medical name for this condition is digital sclerosis (sclear-row-sis). On the hands, you’ll notice tight, waxy skin on the backs of your hands. The fingers can become stiff and difficult to move. If diabetes has been poorly controlled for years, it can f Continue reading >>
Common Diabetes Foot Problems And How To Prevent Them
Common Diabetes Foot Problems And How To Prevent Them Thu, 11/18/2010 - 16:46 -- Richard Morris Foot problems in diabetes can be caused by damage to both large and small blood vessels, which is much more common in diabetes. Foot problems, including nerve damage or peripheral neuropathy, usually begin with vascular disease. Damage to small blood vessels, in particular, appears to be the major cause of nerve damage that results in loss of feeling, or worse pain and burning sensations that bother the feel and legs. Once nerve damage progresses, it triggers loss of motor control and the abnormal gait that results in ulcers and amputations. Preventing foot problems in diabetes begins by preventing the loss of circulation that will result in serious nerve damage. This is relatively easy today if the risks for circulatory problems are recognized early. Keeping the blood pressure below 130/80 is essential for reducing damage to blood vessel walls. Preventing placque formation is also critical. This is done with medications the lower triglycerides and raise HDL, such as gemfibrozil and niacin, and those that lower LDL and make it lighter, such as the statins. Blood vessels walls can also be protected with certain blood pressure meds called ACE inhibitors. Blood flow may be improved with high dose vitamin E, although 1200 mg to 1500 mg a day are usually required for this effect. Signs Of Blood Vessel Problems In The Feet: a pale color of the foot when it is raised pain at night relieved by hanging the feet over the side of the bed Although amputations are 15 times as common with diabetes, about half can be prevented with simple steps that protect the feet: Unfortunately, about 60 to 70 percent of people with diabetes already have at least a mild form of nerve damage. Damage appe Continue reading >>
