People living with diabetes are prone to having foot problems, often because of two complications of diabetes: nerve damage (neuropathy) and poor circulation. Neuropathy causes loss of feeling in your feet, taking away your ability to feel pain and discomfort, so you may not detect an injury or irritation. Poor circulation in your feet reduces your ability to heal, making it hard for even a tiny cut to resist infection.
Having diabetes increases the risk of developing a wide range of foot problems. Furthermore, with diabetes, small foot problems can turn into serious complications.
Diabetes-Related Foot & Leg Problems
Infections and ulcers (sores) that do not heal. An ulcer is a sore in the skin that may go all the way to the bone. Because of poor circulation and neuropathy in the feet, cuts or blisters can easily turn into ulcers that become infected and will not heal. This is a common, and serious, complication of diabetes and can lead to a loss of the foot, leg or one’s life.
Corns and calluses. When neuropathy is present, you cannot tell if your developing corns or calluses. Corns and calluses must be properly treated or they can turn into ulcers.
Dry, cracked skin. Poor circulation and neuropathy can make your skin dry. This may seem harmless, but dry skin can result in deeper cracks that may become infected.
Nail disorders. Ingrown toenails (which curve into the skin) and fungal infections can go unnoticed because of loss of feeling. If they are not properly treated, they can lead to infection.
Hammertoes and bunions. Nerve damage affecting muscles can cause muscle weakness and loss of tone in the feet. After time, unstable feet may develop hammertoes and bunions. If left untreated, these deformities can cause ulcers due to increase pressure areas inside shoes.
Charcot foot. This is a complex foot deformity due to an inability to sense pain. Some neuropathic patients may succumb to foot fractures that they cannot feel and as time progresses, the foot will become significantly deformed. In many cases, the foot may take on a rocker-bottom appearance.
Poor circulation. In diabetes, the blood vessels below the knee often become narrow and restrict blood flow. This prevents wounds from healing and may cause tissue death.
Managing diabetes by controlling the blood glucose (especially hemoglobin A1C) is the primary focus to avoid developing complications.
Your podiatrist can help wounds heal, prevent infection or amputation. Many new surgical techniques are available to save feet and legs, including joint reconstruction and wound healing technologies. Getting regular foot checkups and seeking immediate help when you notice something can keep small problems from worsening. Your foot and ankle doctor works together with other healthcare providers to prevent and treat complications from diabetes.
You play a vital role in reducing complications. Follow these guidelines and contact your foot and ankle surgeon if you notice any problems:
Inspect your feet daily. If your eyesight is poor, have someone else do it for you. Inspect for:
Skin or nail problems: Look for cuts, scrapes, redness, drainage, swelling, bad odor, rash, discoloration, loss of hair on toes, injuries or nail changes (deformed, striped, yellowed or discolored, thickened or not growing).
Signs of fracture: If your foot is swollen, red or hot or has changed in size, shape or direction, see your doctor immediately.
Do not ignore leg pain. Pain in the leg that occurs at night or with a little activity could mean you have a blocked artery. Seek care immediately. These issues can worsen very quickly.
Nail cutting. If you have any ingrown nail problems, hard or thickened nails, or reduced feeling in your feet, your toenails should be properly trimmed.
No “bathroom surgery.” Never trim calluses or corns yourself, and do not use over-the-counter medicated pads.
Keep floors free of sharp objects. Make sure no needles, insulin syringes or other sharp objects are on the floor.
Do not go barefoot. Wear shoes, indoors and outdoors. If you absolutely despise wearing closed shoes, there are many sandals out there that provide a certain level of protection.
Check shoes and socks. Shake out your shoes before putting them on. Make sure your socks are not bunched up.
Have your circulation and sense of feeling tested. Your doctor will perform tests to see if you have lost any feeling or circulation. At California Foot and Ankle Institute, we perform in-house circulation testing with the Revo 1100 Non-Invasive Vascular Testing System.
When Is Amputation Necessary?
Even with preventive care and prompt treatment of infection and complications, there are rare instances when amputation is necessary to remove infected tissue, save a limb, or even save a life.
If you are suffering from diabetic complications, or want to be evaluated to prevent any complications, do not hesitate to call us (949) 833-3406 or request anappointment. Our doctors are well-versed in this condition and can develop an effective treatment course specifically for you.