Diabetes Foot

Understanding diabetic foot problems can be an important step (no pun intended) in learning to manage your diabetes and avoid the more serious complications. Diabetic foot ulcers and the diabetic foot infection that can easily follow should be treated quickly. With nerve damage, the diabetic may not even be aware that they have a cut, sore, blister or diabetic foot ulcer, and so the wound or infection often goes unattended. Since the circulation is also poor, the infections can become gangrene, and amputation may be neccesary. Diabetes foot problems are discussed in some depth in this article.

How do Diabetic Foot Problems Develop?

One of the more serious complcations of diabetes is the diabetic foot problems that emerge after chronic high blood sugars take thier toll. Nerve damage and complications in your circulatory system both play a role in these problems.

Nerve Damage to the Diabetic Foot

Nerve damage to the feet, toes ankles and legs is called peripheral neuropathy. When the nerves are not functioning, it can lead to loss or alteration of sensations and the feet can become numb, somewhat like you might feel when you have a local anesthetic.

There is in this case, a problem for the diabetic in telling the difference between sharp pain and a more dull pain. Consequently major cuts and wounds often go undetected and diabetic foot ulcers can become problematic. If you do not seek medical care, because you do not know you have a problem, this can obviously lead to serious complications.

When normal foot sensations are functioning, you tend to move your foot with litlle or no thought when there is a feeling of pressure, adjusting how you are sitting or walking to decrease or remove the pressure. However without effective feedback from the nerves in your foot ot toe, then that adjustment is not adequately made.

Consequently the area of the foot can become deformed and you can develop callouses, and bony protrusions. Necrosis and ischemic changes can lead to diabetic foot ulcers that are known as plantar ulcers. Microfractures can be another diabetic foot problem. They occur when tiny bones in your foot break; these breaks are often undetected, by the diabetic, but show up on X-rays.

Circuilatory problems and Diabetic Foot Ulcer

In diabetes, the circulation is generally poorer -- and no more noticeably so than in the diabetes foot. The blood vessels harden and they become much narrower. With poorer circulation, the diabetic's ability to fight the diabetic foot infection is held in check. Cuts and diabetic foot ulcers can get out of control. With too little help from your white blood cells, the chances for your body to heal itself without a medical intervention are drastically reduced.

When foot infections develop from diabetic foot ulcers, the medical team needs to get to work quickly. However, given the nerve damage, you are only go to the doctor if you are aware of it, and with little or no pain -- or muffled pain -- it can bee weeks or months before some diabetics seek help. If the blood flow was good, you perhaps could afford to let "nature take its course." If you had been aware of the full pain you would not have waited.

As the diabetic foot ulcer and the infection get worse, gangrene can set in. By then it if often late in the game, and while there still may be time, it may also have progressed to the extent that amputation of a toe, part or the foot or more, is neccesary to save the rest of your leg.

How You Can Help Keep Your Foot

Diabetics with foot problems have been known to go for quite a lengthy time not even noticing that they have a foot ulcer, cut, blister or other wound. If a routine foot inspection is built into your day -- perhaps as part of your bathing or showering -- then it is more likely that you will notice diabetic foot problems quickly enough to seek medical care.

Another important things you can do is get yourself some diabetic shoes. These shoes are fit to your feet and have an insert that cushions the foot as you walk, and also of course is an extra layer of protection between your foot and things you can step on like nails. For a diabetics whose foot has become deformed due to chronic callouses and other changes in the diabetic foot, these shoes are very neccesary. Fortunately insurance companies and medicare usually cover much of the cost, as they see the shoes as an important preventative issue.

Other Diabetes Foot Problems

Another one of the diabetes foot problems is edema. Edema is swelling of the foot, ankle and leg and can be accompanied by a general fluid intake of the body. Edema of the extremities can be be caused by congestive heart failure, but this is easily detected by blood tests your doctor can do. The role of diabetes in edema is less clear, but it likely has something to do with the circulatory problems seen throughout the diabetic complications.

One thing your foot doctor may suggest is an special very tight prescription stockings you can wear, that literally push the blood back up towards your heart. If you have edema, you typically should also keep your leg elevated, and take frequent breaks when you are driving or sitting for long periods of time.

Another problem in diabetes involves some pain in the legs or calves, which can occur with diabetes, probably because of the ischemic changes. It can be brought on by walking uphill or other forms of strenuous walking, but it typicallty will respond to taking a break and resting it.

Of course, as in all complications of diabetes, the thing you have the most control over is your diet and exercize. Tight control of blood sugar and cholesterol is very important. The Diabetes Control and Complications Trial  (DCCT), was one of the most significant research studies to impact diabetic care, and it generally showed that getting blood sugars down to levels that were close to normal could go a long way to impacting many of the diabetes complications.

Intensive treatment, which involved, among other things, getting the hemoglobin A1c as close to 6.0 as possible, resulted in 60% better odds of averting peripheral neuropathy.