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Diabetic Foot Disease: Always Stay a Step Ahead!

By Dr. Daniel Pero –

Diabetic Foot Disease: Always Stay a Step Ahead!Diabetes mellitus is a disease where the pancreas does not produce enough insulin, or the body cannot  effectively use the insulin being produced, this causes the body to improperly use sugar.  Sugar can accumulate in abnormally high levels in the blood and tissues, and negatively affect healthy body functions.

Diabetes is a serious metabolic disease, often affecting the feet as the disease progresses. Today, medicine has advanced significantly in treating the dangerous effects of abnormal blood sugar. The good news is that people with diabetes are living longer, healthier lives.  However, diabetes still causes secondary, indirect complications that affect the feet, eyes, and kidneys.  Diabetic foot disease is primarily caused by two complications of the disease; neuropathy, disease of the nerves and atherosclerosis (also called Peripheral Arterial Disease or PAD), plaque on the inside of the artery walls.

Neuropathy is nerve damage, it either causes a loss of sensation or pain.  This loss of sensation makes it difficult to distinguish between hot and cold or to realize when the foot has been cut or bruised.  You lose the natural senses that protect your feet.  This can result in foot ulcers that are difficult to heal.  Ulcers, cuts, scrapes, burns, and other trauma to your feet that go unnoticed and untreated can lead to serious infections or gangrene. When neuropathy causes pain it can be debilitating, effecting balance and the ability to walk, this can lead to serious injury from falls and limited mobility.  Usually, diabetic neuropathy has a direct relation to the high amount of blood sugar over time.

Atherosclerosis/PAD can lead to poor circulation, adversely affecting the legs and feet.  The tissues no longer receive sufficient oxygen and nutrients from the bloodstream, and the body has difficulty clearing waste products from the cells.  If an infection is present, it is more difficult for the body to naturally fight it off, it is also difficult for the body to deliver adequate amounts of antibiotics through the bloodstream.  Some early symptoms of PAD could include “claudication”, painful leg cramps that occur while walking, and “rest pain”, which are painful cramps while lying down.

Our white blood cells, which fight infection, do not perform effectively when blood sugar levels are higher than normal.  This can seriously compound any foot problem. The body’s defenses may be unable to prevent the development of cellulitis (infection of the skin), abscesses (infection of soft tissue under the skin), or osteomyelitis (infection in your bone).

Skin and nail care is vital for people with diabetes.  The toenails are subject to infection with fungus, and this can lead to dystrophy of the nail growth, causing ingrown toenails and bacterial infections.  If the skin becomes dry and cracked, open sores or fissures can develop, become infected, and are difficult to heal.

Some quick statistics:

  • The incidence of diabetes is increasing at a rapid rate.
  • Diabetes is the leading cause of non-traumatic, lower-limb amputations.
  • The rate of amputation for people with diabetes is 10 times higher than for people without diabetes.
  • After an amputation, the chance of another amputation within 3 to 5 years is as high as 50 percent.
  • Amputation is a risk factor associated with higher mortality rates.

To prevent complications:
Inspect feet daily for cuts, blisters, scratches, redness and swelling, or anything abnormal.  If your eyesight is poor, have them inspected by a caretaker or podiatrist.  Wash feet daily in lukewarm water careful not to burn the skin.  Always dry carefully between the toes and powder feet lightly to keep them dry.  Cut toenails straight across or have them cut by a podiatrist.  Use moisturizer to protect your feet from drying and cracking, but not between toes.  Wear proper fitting shoes recommended by a foot specialist.  And never go barefoot!

A simple foot exam by a professional can reveal signs and symptoms of diabetes, and identify more serious complications that could lead to lower-limb amputations. In many cases, these amputations can be prevented with the proper evaluation, prompt testing, and sufficient treatment.  Diabetics should have their feet checked regularly for signs and symptoms of complications to their disease by a qualified podiatrist trained in the management of diabetic foot complications and their prevention.

INTEGRATIVE FOOT & ANKLE CENTER
Dr. Daniel Pero & Dr. Karl Michel
(561) 293-3439  |  www.integrativefoot.com

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