Common causes and remedies for problem feet
The effects of diabetes on the feet may or may not be detectable in its early stages and it is for that reason all diabetics, especially those with Type 2 diabetes, must be take every precaution to prevent feet problems before they occur and to seek the right treatment when they do.
While treatment for diabetes has greatly improved over the last several years there are preventative measures that a diabetic can take to ensure the health of their feet that can preclude costly prescriptive medications: keeping your feet healthy, protecting them by wearing proper socks, such as diabetic socks and maintaining control of blood sugar level.
If a diabetic is negligent in taking care of their feet, the following problems can occur:
Peripheral neuropathy
Diabetic peripheral neuropathy, or nerve damage, is one of the most common effect of diabetes. It can affect the arms, hands, legs and feet.
The nerve damage that characterizes diabetic peripheral neuropathy is more common in patients with poorly managed diabetes, however, even those diabetic patients who have excellent blood sugar (glucose) control can develop diabetic neuropathy.
There are several theories as to why this occurs, including the possibilities that high blood glucose or constricted blood vessels produce damage to the nerves.
As diabetic peripheral neuropathy progresses, various nerves are affected. These damaged nerves can cause problems that encourage development of ulcers.
For example: Motor Neuropathy (Deformity) coupled with ill-fitting shoes and sensory neuropathy (numbness) can equal ulcers (sores).
There are three different groups of nerves can be affected by diabetic neuropathy:
- Sensory nerves, which enable people to feel pain, temperature, and other sensations
- Motor nerves, which control the muscles and give them their strength and tone
- Autonomic nerves, which allow the body to perform certain involuntary functions, such as sweating.
Diabetic peripheral neuropathy doesn’t emerge overnight but instead develops slowly and worsens over time. Having diabetes for several years may increase the likelihood of having diabetic neuropathy although some patients may have this condition long before they are actually diagnosed with diabetes.
Skin Changes
Diabetes can cause changes in the skin of your feet such as dryness, peeling and cracking due to damaged nerves that normally control the oil and moisture in your feet.
One of the best preventative methods is to always dry your feet after bathing and seal in the remaining moisture in the skin with a skin lotion product.
Calluses
Calluses and corns occur more often and build up faster on diabetic feet. If they are not trimmed, calluses can get very thick, break down and potentially develop into ulcers (open sores).
A word of caution; never try to cut calluses or corns yourself – this can lead to ulcers and infection. Instead let your podiatrist or physician cut trim them. Also, avoid the use of products that contain chemical agents as they can burn your skin.
Using a pumice stone on your wet feet followed by applying lotion every day will help keep calluses under control.
Foot Ulcers
Ulcers occur most often on the ball of the foot, the bottom of the big toe or on the sides of the foot which is usually due to poorly fitting shoes.
Due to poor circulation diabetes and a high blood glucose level infection will slow the healing process of an ulcer in which case infection can easily set in if left unattended or treated. A neglected infection can spread which in turn could leave amputation as the only option to keep it from further spreading to the leg and or bones.
Keeping off your feet is very important as walking can increase the size of the ulcer and force the infection deeper into your foot. (A special shoe, brace, or cast on your foot may be made to protect it depending on its severity.)
In some cases, depending on the progressive state of the ulcer, treating it may require that your physician or podiatrist take x-rays to make sure the bone is not infected and may clean out any dead and infected tissue. A culture may be taken to determine the type of infection and which antibiotic will work best.
After an ulcer heals treat your foot carefully as scar tissue under the healed wound can break down easily. A podiatrist or physician may require that you wear special shoes after the ulcer is healed to protect the area and prevent the ulcer from returning.
Poor Circulation
Poor circulation causes blood vessels of the foot and leg to narrow and harden. If your feet are cold, you may be tempted to warm them. Unfortunately, if your feet cannot feel heat, it is easy for you to burn them with hot water, hot water bottles, or heating pads. The best way to help cold feet is to wear warm socks.
Some people feel pain in their calves when walking fast, up a hill, or on a hard surface. This condition is called intermittent claudication. Stopping to rest for a few moments should end the pain. If you have these symptoms, you must stop smoking. Work with your health care provider to get started on a walking program. Some people can be helped with medication to improve circulation.
Exercise is good for poor circulation. It stimulates blood flow in the legs and feet. Walk in sturdy, good-fitting, comfortable shoes, but don’t walk when you have open sores.
Amputation
People with diabetes are far more likely to have a foot or leg amputated than other people. The problem? Many people with diabetes have artery disease, which reduces blood flow to the feet. Also, many people with diabetes have nerve disease, which reduces sensation. Together, these problems make it easy to get ulcers and infections that may lead to amputation. Most amputations are preventable with regular care and proper footware.
For these reasons, take good care of your feet and see your health care provider right away about foot problems. Ask about prescription shoes that are covered by Medicare and other insurance. Always follow your health care provider’s advice when caring for ulcers or other foot problems.
One of the biggest threats to your feet is smoking. Smoking affects small blood vessels. It can cause decreased blood flow to the feet and make wounds heal slowly. A lot of people with diabetes who need amputations are smokers.
Some important facts 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 form thickly on the feet pads
- Swelling occurs in both legs and feet due to poor circulation
- Peripheral neuropathy (nerve damage)
