How can diabetes affect my feet?
Chronically high blood sugar (glucose) levels can be associated with serious complications in people who have diabetes. The feet are especially at risk. Two conditions called diabetic neuropathy and peripheral vascular disease can damage the feet (and other areas of the body) in people who have diabetes.
What is diabetic neuropathy?
Chronically high sugar levels associated with uncontrolled diabetes can cause nerve damage that interferes with the ability to sense pain and temperature. This so-called "sensory diabetic neuropathy" increases the risk a person with diabetes will not notice problems with his or her feet. Nearly 10% of people with diabetes develop foot ulcers due to peripheral vascular disease and nerve damage. People with diabetes may not notice sores or cuts on the feet, which in turn can lead to an infection . Nerve damage can also affect the function of foot muscles, leading to improper alignment and injury.
What is peripheral vascular disease?
Diabetes is associated with poor circulation (blood flow). Inadequate blood flow increases the healing time for cuts and sores. Peripheral vascular disease refers to compromised blood flow in the arms and legs. Poor blood flow increases the risk that infections will not heal. This, in turn, increases the risk of ulcers and gangrene, which is tissue death that occurs in a localized area when there is an inadequate blood supply.
What are common foot problems of people with diabetes?
The following images show common foot problems that anyone can get; however, those with diabetes are at increased risk for serious complications associated with these conditions, including infection and even amputation.
Athlete's foot
Fungal infection of the feet is called athlete's foot. Cracked skin, itching, and redness are associated with the condition. Fungus enters cracks in the skin causing an infection that must be treated with antifungal medications. Oral medications or topical creams may be used to treat athlete's foot.
Fungal nail infection
Thick, brittle, yellow-brown, or opaque nails are common with fungal nail infections. The infected area may crumble or seem to pull away from the rest of the nail. Fungus thrives in the warm, moist, dark environment created by wearing closed-toed shoes. Nail injury also increases the risk of fungal nail infection. These infections are difficult, but not impossible, to treat. Oral medications work best to treat fungal nail infections. Topical treatments are only effective for a few types of fungal nail infections. Sometimes, surgery is necessary to remove infected areas of the nail.
Calluses
Calluses are hard areas of thickened skin that build up on the bottom of the feet. Uneven weight distribution, a skin abnormality, or ill-fitting shoes may cause calluses. Use these tips to care for calluses:
- Rub the area with pumice stone after a shower or bath. Ask your doctor the best way to do this.
- Place cushioned insoles or pads in shoes.
- Ask your doctor about prescription medication to soften calluses.
It's normal to have some calluses. It's important to never try to cut a callus using a sharp object. Doing so can cause serious injury.
Corns
A corn is a thickened, button-like area of skin that builds up between the toes or near a bony area of a toe. Pressure and friction cause corns. Use these tips to care for corns:
- Rub the area with a pumice stone after a shower or bath. Consult your doctor before doing this.
- Avoid over-the-counter corn removal treatments.
- Never try to cut the corn with a sharp object. Doing so can cause serious injury.
Blisters
Blisters are raised, fluid-filled areas of skin that form due to friction. Popping a blister is not a good way to treat it since the skin covering the area helps guard against infection. To care for a blister, keep the area clean, apply antibacterial cream or ointment, and cover it with a bandage to reduce the risk of infection.
Bunions
A bunion is a sore, red, callused area that forms on the outside of the joint of the big toe. Bunions make the big toe angle inward. They may appear on both feet and tend to run in families. Wearing high-heeled shoes with inadequate toe room increases the risk of bunions by pushing the big toes into an unnatural position. Covering the bunion with padding or a foam cushion helps protect it. Special toe separators and other devices may be used to keep the toes in proper alignment. If the bunion is very painful or unsightly, surgery may be used to alleviate the symptoms.
Dry skin
Dry, cracked skin allows bacteria and other germs to enter your body, potentially causing an infection. Moisturizing soaps, lotions, and other products can help keep the skin barrier soft, intact, and healthy.
Foot ulcers
Foot ulcers are dangerous wounds that can affect people with diabetes. When a minor scrape, skin break, or sore on the foot becomes infected, a sore can result. In people who have diabetes, sores heal slowly or fail to heal. Early diagnosis and treatment are necessary to reduce the risk of complications. Your doctor is the best source of information on how to properly care for a foot sore.
Ingrown toenail
Ingrown toenails derive their name from growing into the skin along the edges of the nail. An ingrown toenail may cause pain, pressure, and even cut into the skin leading to an infection. Wearing tight or ill-fitting shoes increases the risk of ingrown toenails. High-impact activities such as running and aerobics may contribute to the problem. Walking, toe crowding, and inadequately trimmed toe nails may also cause ingrown toenails. The best way to prevent ingrown toenails is to keep the nails trimmed. Professional medical treatment is necessary if an ingrown toenail is severe or if there is an infection. Sometimes surgery is necessary to remove the affected part of the nail and the growth plate from which the nail grows.
Plantar warts
Thickened areas on the soles of the feet that have small black spots or pinholes are likely plantar warts. Plantar warts are caused by a virus. The affected patches of skin are painful and may occur alone or in clusters. It's a bad idea to use over-the-counter remedies to treat a wart. When in doubt, a doctor can determine if a lesion is a callus or a plantar wart.
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