People with diabetes require special attention and care for their feet, as diabetes significantly increases the risk of foot problems. The long-term effects of high blood sugar can damage nerves and blood vessels, leading to a range of foot complications.

Main Foot Problems in Diabetics:

  1. Diabetic Neuropathy:
  • Symptoms: This nerve damage can lead to a loss of sensation in the feet. Affected individuals may not notice injuries, pressure points, or wounds, which can worsen the damage.
  • Risk: Even small injuries can go unnoticed and develop into serious ulcers.
  1. Peripheral Arterial Disease (PAD):
  • Symptoms: Poor circulation can cause wounds to heal more slowly and increase the risk of infections. Common signs include cold feet, pale or bluish skin, and pain when walking.
  • Risk: Reduced blood flow can lead to wounds developing into severe infections, which in extreme cases may require amputations.
  1. Diabetic Foot Ulcers:
  • Symptoms: Open wounds or ulcers on the feet, often occurring at pressure points like under the midfoot (ulcus, mal perforans) or the heels, heal poorly due to the combination of neuropathy and poor circulation.
  • Risk: These ulcers are prone to infection and can penetrate deep into the tissue, making healing even more difficult.
 

Diagnosis and Monitoring:

  • Regular Foot Examinations: People with diabetes should inspect their feet daily for injuries, cracks, redness, swelling, or changes in skin. A doctor should perform a thorough foot examination at least once a year.
  • Monofilament Test: This test is used to check the sensitivity of the feet. A fine monofilament is pressed against different areas of the foot to determine if sensation is impaired.
  • Doppler Ultrasound: This test measures blood flow in the legs and feet to detect issues with arterial circulation.

Preventive Measures:

  1. Daily Foot Care:

  • Cleansing and Moisturizing: Wash your feet daily with warm water and mild soap. Dry them thoroughly, especially between the toes, and apply a moisturizing cream to keep the skin soft. However, avoid applying cream between the toes as this can increase the risk of fungal infections.

  • Nail Care: Cut toenails straight across and file them carefully to prevent ingrown nails. If in doubt, have a professional trim your nails, especially if you have vision problems or limited mobility.

  1. Protection Against Injuries:

  • Proper Footwear: Wear well-fitting, comfortable shoes with enough space for your toes to avoid pressure points and blisters. Avoid tight, ill-fitting shoes and high heels.

  • Avoid Walking Barefoot: Don’t walk barefoot, especially outdoors, to prevent injuries.

  1. Blood Sugar Control: Maintaining good blood sugar levels is crucial to slow down or prevent the progression of neuropathy and circulatory problems.

  2. Minimize Risk Factors: Smoking worsens circulation and should be avoided. Maintain a healthy weight and engage in regular physical activity to promote circulation.

Treatment Options for Foot Problems:

  1. Wound Care:
    For wounds or ulcers, quick and careful treatment is essential. This may include regular dressing changes, pressure relief, and the use of special orthopedic aids to assist healing.

  2. Antibiotics:
    If an infection is present, the doctor may prescribe antibiotics to prevent the infection from spreading.

  3. Surgical Interventions:
    In severe cases, especially with infected ulcers or necrotic tissue, surgery may be necessary to remove the affected tissue or, in the worst-case scenario, to perform an amputation.