There are two most common diabetes foot problems: neuropathy and vascular disease. Uncontrolled diabetes can damage the nerves, making a person unable to feel heat, cold or pain. This can be dangerous because a small cut or sore can become infected, without the diabetic noticing it until a festering ulcer has appeared.
Diabetes also affects blood flow and healing times. Peripheral vascular disease refers to poor circulation in the arms and legs. People who develop infections that do not heal due to poor circulation are at risk for developing gangrene — tissue death — which is a top cause for the 56,000+ people with diabetes who have amputations done each year. The good news is that more than half of these amputations can be avoided through proper diabetic foot care.
Why Do Diabetics Develop Foot Complications?
Anyone can have the following foot issues, but these foot problems can lead to infection and amputation in diabetics. When blood sugar levels are high, the body loses fluid while converting water into urine to remove the excess glucose — and, as a result, the skin becomes dry. Often, damaged nerves do not transmit the message for the body to sweat, so the skin does not get naturally moistened. Dry skin is prone to crack and peel, which offer germs a direct pathway into the body to cause infection.
Our feet are covered in over 100 types of microbes. In order to cause infection, these pathogens must be able to enter the body. Any break in the skin can invite disaster. Diabetes and itchy feet are caused by dryness — and scratching can lead to breaks in the skin. Ingrown toenails, corns and blisters can all be portals for pathogens to seep into the body, too. On top of all that, blood glucose is a great breeding grounds for bacteria and fungus.
A third of people with diabetes will have a skin disorder at some point. The prognosis can be very dire once problems have arisen, says Dr. Peter Joseph, chairman of the Allegheny General Hospital podiatry department. “Fifty percent of patients have a second amputation within three years of the first amputation, and within five years following the first amputation, 50 percent are dead for whatever reason,” he explains. On the bright side, diabetes foot problems are very treatable when detected early and serious diabetes foot complications are very preventable.
Other Common Diabetes Foot Problems:
- Athlete’s Foot symptoms of redness, itching, burning and cracking are caused by a type of fungus. Oral pills or topical creams can be used to treat the fungus.
- Fungal nails are evident by the yellow discoloration and crumbling nail edges. Foot fungus can be very difficult to treat. Interventions may include tearing a portion of the nail off, laser therapy, oral pills, or topical medication.
- Plantar warts look like calluses, but are caused by a virus. Often, warts are painful. Health care providers may prescribe a topical treatment or recommend cryosurgery to remove a particularly stubborn wart.
What Can Be Done?
The Cleveland Clinic recommends that diabetics check their feet daily to prevent a small cut from turning into a big problem. Following the doctor’s advice on diet, exercise and medication can help keep blood glucose levels down. Trimming toenails straight across will prevent ingrown toenails from forming. Wearing socks and closed-toe shoes or slippers at all times — even around the house — can protect the feet from microbes. We also recommend using a UV shoe sanitizer at the end of each day to keep your shoes fresh and free from up to 99.9% of fungus and bacteria.