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Diabetes and Your Feet
Poor circulation in the feet can make it hard for wounds to heal. It can even lead to gangrene of the toes or other portions of the foot. Signs of poor circulation are: Ø Color changes. Watch especially for red, blue, or white. Ø Cool or cold feet Ø Wounds that don’t heal, or take a long time to heal Ø Pain in the legs (most serious if occurs at rest) Ø Swelling of the feet or ankles
The elevated blood sugar that occurs in diabetes can also lead to nerve damage in the feet. This causes loss of sensation, or a “painful numbness” called neuropathy. Loss of sensation is very dangerous, because small injuries go unnoticed, leading to severe infections that can lead to amputation. The podiatrist checks sensation by using a filament that measures the ability to sense light touch (Figure 1). This filament is calibrated to the “protective threshold,” the minimum amount of sensation a patient must have to protect against injury.
Without protective sensation, pressure spots and calluses can break down the skin without the patient even noticing it. This is how an ulcer forms (Figure 2).
The doctors of The North Shore Podiatry Group are experts in the treatment of the pedal complications of diabetes. We employ the latest wound care techniques and materials including bioengineered skin grafts to heal diabetic ulcers. When necessary, we perform selective and limited amputations to preserve as much of the foot as possible.
Diabetic patients are also at greater risk of developing fungal infections, ingrown toenails, dry cracked heels, and other skin disorders. For this reason, diabetic patients should have a foot checkup every six months.
The North Shore Podiatry Group advises our patients to observe the following guidelines: Ø Shoes must fit correctly without any pressure points. Women should avoid high heels and pointed toed shoes. Ø Inspect the feet daily for small injuries, calluses or pressure marks. Ø Use a moisturizing cream on the feet daily to avoid cracked heels and soles. Do not apply cream between the toes. Ø Do not walk barefoot. Instead, use slippers or sandals to protect the soles of the feet. Ø Never use a hot water bottle or heating pad on your feet. This is a common cause of burns in neuropathic patients. Ø Keep toenails cut straight across. It is OK to round the corners with an emery board. Ø Never trim calluses with a sharp instrument. Consult your podiatrist. Ø Never apply over-the-counter acid preparations to remove calluses. This is a common cause of acid burns. Ø See your podiatrist twice yearly for foot check ups.
If you have questions or would like to discuss diabetic foot care, please contact The North Shore Podiatry Group.
The North Shore Podiatry Group
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Diabetes is a disease that affects approximately 16
million people in the United States. Complications of diabetes affect many
organ systems. In the legs and feet, diabetes primarily affects the vascular
and nervous systems. This means that diabetic patients are prone to poor
circulation and loss of sensation in the feet. For that reason, the podiatrist
plays an important role in diabetic foot care. 