Complications of the Foot in Diabetes

Diabetes is a common problem in society today. The costs to the individual and to society are high. At the same time so much can be done to prevent it and ameliorate the consequences of diabetes. Foot problems are common in those with diabetes and the outcome of them can have serious implications. Some of these complications include things like foot ulcers that can develop a spreading infection. Amputations due to non-healing wounds with poor circulation also sometimes need to be carried out. There are many features of diabetes that affect the foot that can lead to these complications.

One of these features is that of neuropathy. This is where the higher blood glucose levels associated with diabetes can damage the nerves and affect sensation. When this neuropathy is present, it means that when there is damage to the foot that there is no pain or warning signal of that damage. For example, it could be as simple as a blister or as bad as stepping on a rusty nail or spraining your ankle. It is not hard to imagine just how much damage could be done by these if you can not feel the damage, especially if you keep walking on that damage. Often in these cases, seeing a swollen foot may be the first sign. This is why those with diabetes are encouraged to inspect their feet daily to make sure there is nothing wrong and if there is something wrong, that they get urgent medical assistance. A very good control of the blood glucose levels are needed to ensure that this nerve damage is prevented from happening.

Another feature that develops in long-standing diabetes is that of poorer circulation. Good circulation is needed to keep the tissues heathy and less prone to damage. Good circulation is also needed to help bring the agents that are needed to fight infections and help heal wounds, so if damage does occur, then it is possible to heal up properly after that damage. This process is impaired in those with diabetes. Other things than just diabetes can affect the circulation such as dietary habits and activity levels. Increased levels of physical activity in those with diabetes have been shown to improve the status of the circulation and should be encouraged.

Podiatrists will almost always check the nerve supply and circulation every time that they see a patient with diabetes for these reasons and give advice based on the status of the nerves and the circulation. Podiatrists will monitor the foot for any changes that may turn into serious complications and treat any problems, such as corns and callus that may predispose to the diabetes related complications. The podiatry related live show, PodChatLive did an episode on the foot in diabetes were the hosts of the show chatted with the podiatrist and diabetic foot expert, Dr David Armstrong DPM. They talked about just how common and how serious the complications of the foot are in those who have diabetes. The episode if well worth a listening to.

Craig Payne is a University lecturer, runner, cynic, researcher, skeptic, forum admin, woo basher, clinician, rabble-rouser, blogger and a dad.