One of the first things you’ll learn after diagnosis is how diabetes can affect your circulatory and nervous systems. People with diabetes are more likely to have damage to their nerves and cardiovascular system. Diabetes can ultimately lead to a condition called peripheral neuropathy, which is when your nerves become damaged or dysregulated. It can also contribute to a disease called PAD, or peripheral artery disease. PAD causes poor circulation.
Pain and Loss of Feeling
Some of the first symptoms of peripheral neuropathy are pain and tingling sensations. You could also experience numbness, and some people with nerve damage don’t experience symptoms at all. Notify your doctor at the first sign of nerve damage. The sooner you begin to address the issue, the more likely you are to prevent further damage.
Injuries Heal Slowly
As we age it takes time to heal from our injuries. If you have diabetes, healing can take even longer due to poor circulation, especially if you have peripheral artery disease. This can make healing an injury on your feet a difficult ongoing task. If you injure your foot and it does not heal at a normal pace, you’ll need to mention this to your doctor. They will want to monitor the progression of your healing and intervene if you show any signs of developing an infection.
If you have an injury on your foot that fails to heal in a timely manner, it could become a foot ulcer. About fifteen percent of all diabetes patients will have a foot ulcer at some point. A foot ulcer is a breakdown of the skin, usually on the bottom of your foot, that exposes the tissues beneath the skin.
If left unaddressed, foot ulcers can reach the bone. Foot ulcers are painful, but a patient with diabetes may not notice an ulcer at first if they already have nerve damage in their feet. A treatment plan for ulcers may include medication to mitigate infection and help with blood flow. Your doctor or podiatrist may recommend that you do not bear weight on your injured foot. Some patients may find surgery as a necessary procedure to promote healing by removing diseased tissue and grafting new skin.
Toe and Foot Amputation
In extreme cases, the amputation of the toe or foot may be necessary. Foot ulcers can become infected, which is a dangerous situation for a patient with diabetes. An unaddressed infected foot ulcer can lead to sepsis or gangrene. Both poor healing that causes sepsis, and poor circulation that causes gangrene, can be attributed to diabetes.
There are treatments both for sepsis and gangrene, but they require prompt medical attention. If this kind of infection is left untreated for too long, toe or foot amputation may be the next choice to prevent the infection from spreading. Diabetes is the main cause of non-traumatic foot amputations, and the CDC estimates that up to fifty percent of foot amputations caused by diabetes could have been avoided with preventative foot care.
Preventative Diabetic Foot Care
If you have diabetes, the best thing you can do to prevent foot ulcers is to take care of your feet. You should wear well-fitting shoes to prevent hot spots or blisters. These small blisters can become worse due to a diabetic’s slow healing process.
Check your feet every day for any hot spots, cracks, or other injuries. Make note of any sore spots and make sure to check on them the next day for signs of healing. If you are not healing, make an appointment with your doctor or podiatrist to address this and get you on a path to healthy feet.
Don’t use very hot water when washing your feet. If you have nerve pain, you may not notice the difference between hot and cold as well as you use to. It’s much easier to burn your feet this way. Always test the water first before washing your feet.
Try not to go barefoot, and always protect your feet with socks or slippers. You may not notice small injuries. Even tiny abrasions could become worse due to poor circulation and healing. You should also promote circulation in your feet by wearing compression socks, exercising regularly, and not sitting for too long.
If you tend to have problems with your shoes fitting comfortably, ask your podiatrist about custom orthotics. A custom fit in your favorite shoe could help it to rub less against your feet. If you are anxious about starting foot care when you have diabetes, you should work with a team that knows exactly how to help you.
Horizon Foot and Ankle Institute is here to answer any questions you have about diabetes and foot care. We are experts in treating patients with diabetes and will help you understand the role you both play in mitigating your diabetes symptoms.