By Bryce Paschold, DPM, Orthopedic & Sports Enhancement Center
Diabetes has been gaining increasing notoriety over the past few decades. According to the American Diabetes Association, there are 1.4 million newly diagnosed cases of diabetes each year in the United States. This leads to a total of 29.1 million, or roughly 9 percent, of Americans who suffer from diabetes. These are astounding facts, and these confirm that diabetes has truly become an epidemic in our country. Aside from the tedious monitoring and glucose management that is involved with handling diabetes, it also has been found to be the seventh deadliest disease in this country, accounting for around 69,000 deaths annually and another 234,000 related deaths.
What makes this disease so deadly? It is primarily due to the involvement with multiple other organ systems, including heart disease, eye manifestations and blindness, kidney disease, and foot ulcers and infections. According to the American Diabetes Association, it is estimated that there are at least 73,000 lower limb amputations performed annually in diabetics. The worst part about this striking statistic: most of these probably could have been prevented.
You may ask why people with diabetes have foot problems. Nerve degeneration can occur as blood sugars are elevated and become more out of control. The first place that nerve damage usually occurs is the farthest away from the spinal cord, which includes the fingers and toes. As this occurs, diabetics feel numbness, burning, or tingling, and may start to lose feeling in these areas. This is otherwise known as neuropathy and is usually the main culprit of diabetic foot problems. As neuropathy progresses, diabetics continue to lose sensation, which can progress up the feet and even into the legs. When sensation is lost, problems such as blisters, calluses, or cuts start to go unnoticed. These small, benign problems that typically resolve in a matter of days for healthy people without diabetes can be the start of an ulcer, infection, or even amputation in a poorly controlled diabetic.
Diabetics may also have poor circulation (also known as peripheral arterial disease), so a minor cut may not heal in a timely fashion like in a healthy person. This is generally the vicious cycle that involves foot problems in diabetics. First, they get a blister that they do not feel due to the neuropathy, then this blister does not heal and progresses to an ulcer because of their poor blood flow, and as the ulcer continually fails to heal, the risk of infection and therefore amputation continues to rise. The people who have diabetes who neglect their feet are usually the ones that will have future foot issues. Prevention of diabetic foot problems such as ulcers, infections, and even amputations begins with being proactive.
To prevent this morbid chain of events from happening, here are a few tips regarding proper daily diabetic foot care.
- Check your feet daily for any blisters, calluses, corns, sores, ulcers, dry skin, or signs of athlete’s foot. Seek medical attention (regular medical doctor or podiatrist) immediately if any of these should arise.
- Wear closed-toe shoes at all times while walking, even when indoors! Avoid going barefoot or wearing sandals, flip-flops, or house slippers. This will help to prevent any cuts or scrapes or stepping on anything that you might not feel.
- Apply lotion to feet daily, especially during the winter months, to prevent cracking and dryness. Avoid applying lotion in between toes as there is not enough airflow for this space to dry thoroughly.
- Do not attempt to trim toenails or calluses yourself if you have neuropathy! Seek professional care with a podiatrist.
- See a podiatrist for preventive diabetic foot checks; they will then tell you how often to return.
A few simple precautions can help to prevent future foot problems before they start. If you are not currently a diabetic, do everything in your power to keep from getting this deadly disease. This includes regular exercise and eating right as well as regular check-ups by your medical doctor. As in many other aspects of medicine and health, prevention reigns supreme!
Dr. Bryce Paschold, DPM, provides a complete range of foot and ankle services for patients of any age. He is board certified and subspecializes in foot and ankle sports medicine. For any foot or ankle-related problem, no matter how big or small, please feel free to contact Dr. Paschold at the Orthopedic & Sports Enhancement Center at 309-663-9300, visit their Facebook page, or check out their website at www.sportsenhancement.net.
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