The Effects Of Diabetes On The Feet and Legs
Posted on November 10, 2009
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Diabetic neuropathy is a form of nerve damage caused by diabetes that can effect nerves throughout the body. This type of nerve disorder can occur every organ system, including the digestive tract, heart, and sex organs. Diabetes can particularly effect the extremities. When nerve damage presents a risk of damage to the nerves in the feet, this can lead to foot wounds and if not treated cause ulcers (wearing diabetic socks is one superficial type of therapy that can greatly help to prevent ulcers). These symptoms are often worse at night.
The symptoms that effect the feet and legs of may include:
- numbness or insensitivity to pain or temperature
- a tingling, burning, or prickling sensation
- sharp pains or cramps
- extreme sensitivity to touch, even light touch
- loss of balance and coordination
Around 60-70 percent of diabetics have some form of neuropathy. Diabetes can develop the nerves at any time with the risk increasing with age and duration – the highest rates of neuropathy occurs in diabetics who have had the disease for at least 25 years. Nerve damage is also more common in people who have problems controlling their blood glucose as well as those with high levels of blood fat, blood pressure, and the obese.
For diabetics Damage to blood vessels (vascular disease) can also occur. Both of these complications, in concert, will cause poor circulation, which can lay the groundwork for more serious complications such as blood clots, blood pooling, and edema, thereby not only effecting to your feet and legs, but your entire system, especially the heart. While Some diabetics with nerve damage will have no symptoms, others may experience pain and or tingling, followed by numbness or loss of feeling.
Some important facts to know about the effects of diabetes on the legs and feet:
- 1 in 6 diabetics will develop a foot ulcer during their lifetime.
- Diabetics are 25 times more likely to lose a leg due to an ulcer.
- Up to 70% of all leg amputations occur in people with diabetes.
- Foot ulcers can result from a blister or sore that may develop on the foot due to poorly fitting socks and shoes and increased the amount of friction from perspiration.
- Calluses on the feet
- Swelling in both legs and feet due to poor circulation
- Peripheral neuropathy (nerve damage)
SPECIFIC FOOT PROBLEMS
Foot ulcers and neuropathic fractures
Two foot problems that need to be prevented from developing are foot ulcers, a complication that usually develops as result of ( nerve damage (Diabetic foot) and neuropathic fractures (Charcot’s foot).
The ulcer associated with nerve damage is found on the non-bony areas of the foot, is irregularly shaped, and depending on the degree of the neuropathy, can sometimes be painful. Diabetics who develop this type of ulcer are more susceptible to infection from minor traumas (e.g. blisters from poorly fitting shoes, toenail problems, pressure or thermal injuries, cuts or scraps from walking barefoot). If the infection is left untreated, gangrene could set in, and ultimately amputation would be required.
The ulcer is that develops with Charcot’s foot is painless, circular in shape, and is usually located on the bony areas of the foot. Deformity, tight shoes, delayed healing of cuts or scraps, heavy calluses, blisters, muscle weakness, limited range of motion, and dry skin are all associated with this type of ulcer.
Diabetic peripheral neuropathy
This is a condition that doesn’t emerge overnight. Instead, it usually develops slowly and worsens over time if left untreated. Some patients have this condition long before they are diagnosed with diabetes. Having diabetes for several years may increase the likelihood of having diabetic neuropathy. Numbness, tingling, or pain or burning sensation (some forms of neuropathy can cause pain) are some of the common signs of neuropathy in the foot or lower limb. Over time, high levels of glucose can cause damage to the nerves and blood vessels. Damage to the blood vessels puts a diabetic at risk of incurring Deep Vein Thrombosis (blood clotting). In concert those two along with poor circulation in the feet and legs, can develop insensitivity or a loss of ability to feel pain, heat, and cold and as a result diabetics can incur minor cuts, scrapes, a blood blister, or pressure sores that they may not be aware of. Also, normal sweat secretion and oil production that lubricates the skin of the foot is impaired, which in combination, can lead to abnormal pressure on the skin, bones, and joints of the foot during walking and can lead to breakdown (or splitting) of the skin of the foot and leg.
Charcot foot
Damage to blood vessels and impairment of the immune system from diabetes make it difficult for these types of wounds to heal. Bacterial infection of the skin, connective tissues, muscles, and ultimately to the bones ( this can result in getting Charcot foot – a condition in which the bones of the foot are weakened enough to fracture. With continued walking, the foot eventually changes shape. As the disorder progresses, the joints collapse and the foot takes on an abnormal shape, such as a rocker-bottom appearance). These infections can easily develop into gangrene. Because of the poor blood flow, antibiotics cannot get to the site of the infection easily. If it progresses to that point, quite often the only treatment for this is amputation of the foot or leg and even worse, if the infection spreads to the bloodstream, this process can be life-threatening.
Prevention
As a preventative measure, diabetics must constantly monitor their feet to avoid severe consequences. With a diabetic foot, a wound as small as a blister from wearing a shoe that’s too tight can cause a great deal of damage and because diabetes decreases blood flow even the smallest skin injury is slow to heal. When your wound is not healing, it’s at risk of infection and if left unattended can ultimately lead to amputation. It’s estimated that 50% foot of those ulcers as well as leg amputations could have been avoided if the patient made some modification to their activities by taking proper measures to ensure that the feet care remain healthy.
Diabetic 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, keeping your feet healthy, wearing diabetic socks, and maintaining good control of blood sugar level, remains the best way to prevent diabetic complications. It’s very important for diabetics to educate themselves and take the necessary precautions to prevent all foot related injuries. Daily observation of the feet is critical and when necessary, wearing either support socks, or support stockings or both. When a diabetic patient takes the necessary preventative footcare measures and understands and practices good foot health, he or she reduces the risks of serious foot conditions.
Achilles tendon thickness (ATT)
The effect of diabetes on the Achilles tendon may contribute to the long-term complications in the foot-ankle complex with respect to the relationship between the disease and the tendon’s thickening.
In controlled analysis between female diabetics patients with type 2 diabetes and female non-diabetics, thickening of the Achilles tendon is found to more common in the former, but no significant difference could be found between type 2 diabetic male patients and their non-diabetic controls. This might indicate a possible impact of diabetes on the ATT depending upon gender, but other physical deficiencies or diseases may also contribute to thickening of Achilles tendon.
Understanding how diabetes effects the feet and legs as well as proactively take every precaution to manage the disease will help a diabetic live and longer and healthier life.
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