A diabetic foot is any pathology that results directly from peripheral arterial disease (PAD) and/or sensory neuropathy affecting the feet in diabetes mellitus; it is a long-term (or "chronic") complication of diabetes mellitus. Presence of several characteristic diabetic foot pathologies such as infection, diabetic foot ulcer and neuropathic osteoarthropathy is called diabetic foot syndrome.
Insulin is a hormone that helps the body deal with sugar (glucose) in the diet. When diabetes is present, either the body produces less or no insulin (Type 1) or the body tissues are resistant to the effects of diabetes (Type 2). This results in higher levels of glucose in the blood, which can damage a whole range of body tissues and organs.
The foot is especially affected by diabetes because:
-diabetes damages the nerves
-diabetes also affect the circulation.
-those with diabetes are more prone to infection
-diabetes can also affect the joints, making them stiffer
-other diabetes complications that can also affect the foot, for example, kidney disease and eye disease.
In diabetes, peripheral nerve dysfunction can be combined with peripheral artery disease (PAD) causing poor blood circulation to the extremities (diabetic angiopathy).Around half of the patients with a diabetic foot ulcer have co-existing PAD. Vitamin D deficiency has been recently found to be associated with diabetic foot infections and increased risk of amputations and deaths.
Where wounds take a long time to heal, infection may set in, spreading to bones and joints, and lower limb amputation may be necessary. Foot infection is the most common cause of non-traumatic amputation in people with diabetes.
Preventing foot problems is essential for people who have diabetes. Keeping feet healthy is critical, and a person should be vigilant about foot hygiene. They can take the following steps:
- Check the feet each day: Examine the feet daily, or ask someone to check for any changes or injuries.
- Wash the feet daily: Keep the feet clean to prevent infections.
- Wear supportive shoes and socks: Protect the feet in socks and shoes at all times. A podiatrist may recommend special shoes to help prevent deformities. Do not apply socks so tightly that they restrict blood flow.
- Promote blood flow to the feet: Put the feet up when sitting, wiggle the toes periodically, and get enough exercise. These actions help promote healthy blood flow to the feet.
- Trim nails carefully: Trim toenails straight across and keep them short. Rounded nails can grow inward, leading to infection.
- Care for corns and bunions: Treat corns and bunions carefully. Never shave corns, as this increases the risk of infection.
- Protect feet from extreme temperatures: Exposure to extreme hot and cold can damage the feet of people with diabetes.
- Receive regular examinations on the feet: Regular examinations by a doctor are key to preventing infections, amputations, and severe deformities.
- Control blood sugar: Uncontrolled blood sugars increase the risk of podiatric complications from diabetes.
- Avoid smoking: Smoking adversely affects blood flow to the tissues, which can make foot problems worse in people with diabetes.