Diabetes or any long term complication of diabetes can affect your feet known as the Diabetic Foot. When more than one characteristic diabetic foot pathologies are present at the same time the condition is then known as the Diabetic Foot Syndrome.
Most common diabetic foot problems are
1. Diabetic foot ulceration
2. Diabetic foot infections
3. Charcot joints, means the progressive degeneration of a weight bearing joint eventually leading to deformity.
RISK FACTORS FOR THE COMMON FOOT PROBLEMS IN DIABETES
The most common risk factors are;
- Peripheral Neuropathy, Structural foot deformity, Poor circulation in association with Peripheral vascular occlusive disease and Infection.
- The whole sequence of events can be understood with the help of the following example, peripheral neuropathy impairs foot sensation so that even a minor injury can go unnoticed, worsen and become invaded by pathogenic bacteria.
- Poor circulation can make the situation worse by impeding the body s infection fighting system.
- The white blood cells, the first line of our defense system; the antibodies, very potent defenders of our body against intruders and other defenders can’t reach the infected areas due to poor circulation and the end result is a non healing ulcer and a minor cut or even an in growing toe nail can become so severely infected that a toe or foot may be amputated.
FOOT ULCERS, INFECTIONS AND CHARCOT FOOT
Foot ulcers are very dangerous and need immediate attention, if not taken care of immediately by a professional the infection might travel deeper through the skin layers and reach the bone involving it. Toes are most vulnerable to infection and most of the times it starts with an in growing toe nail. People with severe peripheral neuropathy are more prone to Charcot foot; a condition that involves bone destruction, bone resorption and eventually deformity and loss of function. It starts when a minor trauma to the joint or bone goes unnoticed and because no changes are made to avoid further damage and no measures is taken to treat that condition including change in exercise program or footwear so the condition worsens leading to the destruction of the joints.
TAKING CARE OF YOUR FEET
1. Examine your feet everyday for any sores, cuts, breaks in the skin. Look in between the toes regularly as well
2. Use warm water and soap to wash your feet everyday and then dry them with care, avoid soaking.
3. Use a moisturizing cream to massage to help to get rid of dryness and thus reduce the chances of cracking which can lead to skin infection
4. Take good care of your toe nails to avoid in growing toe nails .If you think that your nail has started to grow inwards immediately seek professional help, don’t experiment on yourself it might be really dangerous.
5. All corns, warts or calluses must be dealt by a podiatrist.
6. Don’t try anything too hot or too cold on your feet
7. You should wear well fitted, comfortable shoes.
8. Avoid going barefooted; this will help to reduce the risk of getting injury to the foot
9. Consult your doctor if you notice an unusual or non healing injury to your foot
GENERAL MEASURES YOU CAN TAKE
Good control of your blood sugar levels, exercising regularly, quieting smoking as it increases the risk of peripheral vascular disease are some of the general measures you can take to keep your feet healthy and free of diabetic complications or at least delay them.
DIAGNOSIS AND MANAGEMENT
Diabetic foot ulcers are the most common conditions leading to lower limb amputations. A timely diagnosis and prompt treatment may save a limb from the irreversible damage leading to deformity and disability. The family physician has a central role in prevention or early diagnosis of diabetic foot complications. Management requires awareness of the risks for amputation, frequent routine evaluations from your doctor, and good preventive care. A careful physical examination for neuropathy and non invasive testing for arterial insufficiency can detect patients at risk of developing foot ulcers. Role of multidisciplinary team approach cannot be overlooked, which involves your family physician and a diabetic specialist, the ultimate aim being preventing the foot complications as well as intervening at the appropriate time to reduce the risk of lower limb amputations and thus helping patients to live a life free of disability.