|
Diabetes |
|
|
Diabetes Related Foot Problems:
Foot problems are the leading cause of hospitalization for the estimated 8 million Americans living with Diabetes Mellitus. Expenditures related to foot problems caused by Diabetes total hundreds of millions of dollars annually. It is estimated that 15% of people that have diabetes will encounter a serious foot problem at some time in their lives. Common problems include infections of the skin and bone due to bacteria and infections of the nails and skin due to fungus. Some severe infections may lead to gangrene that leads to amputation of a toe, foot or leg.
Most of these problems are preventable through proper care and regular visits to your podiatric physician. Dr. Still likes to work as part of a team with your primary care provider, internist or endocrinologist. Dr. Still can perform a thorough exam on your first visit and discuss preventative care to avoid foot problems associated with diabetes.
Daily foot inspections by the patient or family member, regular visits to the podiatrist and early recognition of problems are vital to maintaining proper foot health with diabetes.
Foot problems in persons with diabetes are usually the result of four primary factors: peripheral neuropathy (nerve damage), poor circulation (peripheral vascular disease), decreased resistance to infection and foot deformities.
A person with diabetes may develop peripheral neuropathy which can lead to decreased ability to detect sensation, temperature and vibration. It is estimated that 20-30% of persons with diabetes will develop peripheral neuropathy. It is less likely in persons who maintain good control of their diabetes through their regular doctor. Peripheral neuropathy allows injuries to remain unnoticed and untreated for lengthy periods of time. It may cause burning or sharp pain in the feet or legs. This pain may interfere with sleep.
Ironically, painful neuropathy may occur in combination with a loss of sensation. Neuropathy can also affect nerves that supply muscles in your feet and legs. This can lead to muscle weakness and atrophy which can lead to common foot deformities such as bunions, hammertoes and joint mal-alignment.
Peripheral vascular disease is unfortunately common in persons with diabetes. It can be substantially worsened if a person also smokes. This impaired circulation can cause pain in the calves or buttocks when walking. The symptoms can increase to severe cramping or pain at rest. There are also associated color and temperature changes. The toes may be frequently red and cool to the touch. Skin changes are common with the skin becoming shiny, taut and lacking hair growth. The toenails often become discolored and infected with severe nail fungus.
Poor circulation results in reduced blood flow to the feet and this restricts the delivery of necessary oxygen and nutrients that are required for normal maintenance and repair. The ability to heal injuries, sores and cuts can be significantly reduced.
Persons with diabetes are also more prone to infections of bacteria and fungus. This is due to the fact that the ability of the white blood cells to fight off infection is reduced. In addition, high blood sugars, impaired circulation and nerve pathology can greatly increase the chances of a mild or severe infection developing quickly.
As stated previously a person with diabetes can avoid these problems by seeing their regular doctor and podiatrist regularly. Proper shoes and protection are essential. Most insurance, including Medicare cover for one pair of shoes and three pairs of custom made soft insoles for persons with diabetes mellitus. All patients who qualify are encouraged to use this benefit.
For more information and tips on proper footwear contact the office of Dr. Still. Websites for the American Diabetes Association and American Podiatric Medical Association are also great resources for information.
|
|
