What is Diabetic Foot?
Understanding the term ‘diabetic foot’ is essential to recognizing its potential impact and how best to manage it. Diabetic foot refers to an array of foot conditions and complications often observed in people living with diabetes. These include foot ulcers, infections, and severe damage to the tissues of the foot, which can lead to amputation in the most serious cases. In fact, diabetes is the leading cause of non-traumatic lower limb amputations worldwide.
One of the main factors leading to diabetic foot is peripheral neuropathy, a condition characterized by nerve damage in the extremities of the body. It results in reduced sensitivity to pain and temperature, making individuals less aware of injuries or wounds on their feet. Consequently, a minor foot injury can progress to a severe condition before it’s even noticed.
Understanding Diabetic Neuropathy
About half of people with diabetes develop diabetic neuropathy. It is categorized into four types: peripheral, autonomic, proximal, and focal. Of these, peripheral neuropathy is the most common and often affects the feet and legs.
Peripheral neuropathy can lead to various foot complications, including diabetic foot ulcers and Charcot foot (a condition that causes weakening of the bones in the foot). Autonomic neuropathy can disrupt the natural process of sweating and oil production in the foot, leading to dry and cracked skin, which can become a gateway for infection.
Diabetic Foot Ulcers
Diabetic foot ulcers are a significant complication of diabetic foot. These open sores usually form on the bottom of the foot and can penetrate deep into the tissue, sometimes reaching the bone. While not all foot ulcers lead to serious complications, it’s worth noting that 85% of lower limb amputations in people with diabetes begin with a foot ulcer.
Prevention is the best approach to managing foot ulcers. This can be achieved by practicing good foot care, including daily inspection of the feet, maintaining proper foot hygiene, wearing appropriate footwear, and controlling blood sugar levels. Regular pediatric care is essential for those with diabetes.
Charcot foot is a severe complication characterized by the weakening of the bones in the foot that can occur in people who have significant nerve damage (neuropathy). It starts with redness, warmth, and swelling, and if not treated promptly, can cause the foot to become deformed.
Early diagnosis of Charcot foot is critical to successful treatment. If you have diabetes and experience any changes in foot shape, swollen feet, or redness and heat in the feet, consult your podiatrist immediately.
Managing Diabetic Foot
Given the high risk of complications, people with diabetes should be proactive in their foot care. Regular pediatric check-ups are important, and a yearly comprehensive foot examination is recommended for all people with diabetes. This examination includes testing for loss of protective sensation, peripheral artery disease, foot deformities, and skin inspection.
Daily self-inspection of the foot is an essential practice to promptly detect any abnormalities or injuries that might otherwise go unnoticed due to neuropathy. This should include a thorough check of the soles and between the toes.
Choosing appropriate footwear is equally important. Shoes should be comfortable, fit well, and provide adequate protection to prevent injuries. Custom therapeutic shoes might be necessary for some individuals to prevent pressure points that can lead to ulcers.
Proper glycemic control can’t be overemphasized. Maintaining blood glucose levels within the recommended range can significantly slow the progression of neuropathy and improve wound healing.
Despite all preventative measures, if you have diabetes and develop a foot wound or notice any changes in the shape, color, or sensation of your feet, seek immediate medical attention. Early intervention can often prevent more serious complications.
The Bottom Line
Managing diabetic foot involves a comprehensive approach that combines self-care, medical interventions, and lifestyle modifications. Regular check-ups, proper foot hygiene, suitable footwear, and good glycemic control are all key components of this strategy. By taking these steps, individuals with diabetes can significantly reduce their risk of developing foot complications and enjoy a better quality of life.