Diabetes: Feet

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Diabetes afflicts over 17 million Americans and is the seventh leading cause of death in the United States. The good news is that it’s treatable, even preventable. But the bad news is that severe cases can lead to gangrene or amputation of the toes, feet and possibly the leg.

Dr. Michael Downey, Chief of the Division of Podiatric Surgery and Medicine at Presbyterian Medical Center, joins Suzanne to explain the causes of diabetic foot disease and what we can do to treat this condition.

What is Diabetes?

Insulin is a hormone produced by the pancreas that is needed for your body to convert sugar, starches and other foods into energy. When someone has diabetes, excessive sugar builds up in the blood as a result of the body’s inability to generate and properly use insulin. Therefore, it is vital to acquire insulin through other ways, such as injection.

While diabetes strikes those of all ages and races, it is most prevalent in African-Americans, Latinos, Native Americans, Asian-Americans and the senior population.

The cause of diabetes remains a mystery, but genetics and physical traits such as obesity and lack of exercise are said to be contributing factors. It often goes undiagnosed because the symptoms may seem so common and harmless. Education is the key to prevention.

What Can Happen to My Feet?

Those with diabetes often have problems with their feet for a number of reasons. The most prevalent problem, however, is loss of sensitivity. Sometimes diabetic patients lose feeling in their feet and are unable to sense a blister, or something so sensitive to others, such as walking across hot sand. If a blister is not taken care of, it can degenerate and develop into an ulcer. And if an ulcer becomes infected, hospital care may be the only option. At its worst, a diabetes foot problem can lead to amputation.

Dr. Downey also mentioned three disease conditions in which diabetes can affect the feet. Angiopathy can result in blood clots or blood vessels that are too weak and block the flow of blood in the foot. In turn, this severe condition can lead to gangrene and perhaps a loss of toes. Immunopathy can cause impairment to the body’s immune system. Neuropathy can cause no feeling or a lack of sensation in the foot, leading to danger such as stepping on a nail and induced infection without being aware of it. To get further information on these topics, check out the links.

Diabetes Foot Care

Proper diet, exercise and sufficient medication should all be at the top of a diabetic’s daily checklist. But when it comes to your feet, protection is key. Dr. Downy recommends inspecting your feet on a daily basis; if you can’t bend over to reach them, use a mirror. Also, make sure to bathe your feet properly and gently; also, dry your feet very well. This means using a soft towel in between each of your toes where problems can occur if left with an excess of moisture.

Some other ways to protect your feet from infection are:

• Wash your feet every day with lukewarm (not hot) water and mild soap.
• Keep the skin of your feet smooth by applying a cream or lanolin lotion, especially on the heels. If the skin is cracked, talk to your doctor about how to treat it.
• Keep your feet dry by dusting them with nonmedicated powder before putting on shoes, socks or stockings.
• Call your doctor at the very first sign of redness, swelling, pain that doesn't go away, or numbness or tingling in any part of your foot.
• Don't treat calluses, corns or bunions without talking to your doctor first.
• Cut toenails straight across to avoid ingrown toenails. It might help to soak your toenails in warm water to soften them before you cut them.
• Don't let your feet get too hot or too cold.
• Don't go barefoot.