Diabetics at Higher Risk for Foot Problems

By John M. Sigle, DPM, FACFAS

This year marks the 78th Anniversary of the American Diabetes Association (ADA). Each November, tens of thousands of Americans join the ADA’s crusade to heighten the nation’s awareness of diabetes and to inspire millions of people who are impacted by the disease to live healthy and active lifestyles.

According to the U.S. Department of Health and Human Services, more than 30 million people in the United States have diabetes. Diabetics are at a higher risk for developing foot problems than non-diabetics. Among the diabetic population, foot complications lead to higher rate of sickness and disease as well as higher mortality rates.

Approximately 25 percent of diabetics will develop a foot ulcer that accounts for two-thirds of all non-traumatic amputations; however, 70 percent of amputations can be prevented if simple measures are taken.

“According to the U.S. Department of Health and Human Services, more than 30 million people in the United States have diabetes.”

Podiatrists play an important role in the prevention of amputations. Early recognition and regular foot screenings by a podiatrist are key in amputation prevention. Peripheral neuropathy and peripheral vascular disease are the two major foot problems that affect diabetics.
Peripheral neuropathy

Peripheral neuropathy can cause nerve damage that lessens the ability to sense heat, cold, and pain. Typically, a person with this condition is not able to feel an irritation or even notice when they have a problem. Consequently, a loss of feeling and awareness leads to injuries like blisters, cuts, sores, and infection. This condition also impairs gait (walking) and leads to balance problems and falls.

Peripheral vascular disease
Diabetes damages blood vessels and arteries. Fatty deposits in the vessels can hamper blood flow to the heart and brain as well as hands and feet. When affecting the lower extremities, this condition leads to leg pain, slow healing wounds, infection, gangrene (tissue death), and amputation.

Both conditions are serious and have to be closely monitored. They can lead to serious problems such as wounds and foot ulcers that do not heal, skin abscesses, and even infections to the bone.

Prevention
Most of us pay little attention to our feet compared to other parts of our body. This is a problem, especially if you have diabetes. Regular inspection of your feet is essential on a daily basis. It won’t cost you a nickel, and it is one of the best ways to prevent foot complications.

There are many other things you can do to care for your feet. Here are some tips:

• Wash your feet daily.
• Keep circulation flowing in your feet when inactive.
• Be active and exercise regularly.
• Always protect your feet by wearing thick soft socks and shoes.
• Protect your feet from extreme temperatures.
• Moisturize your skin regularly.
• Trim your nails carefully.
• Be properly measured and fitted when purchasing new shoes.
• Wear comfortable shoes that fit properly.
• Avoid wearing anything that is too tight around the legs.
• Do not remove calluses, corns, or warts by yourself.
• Seek medical attention to get rid of toenail fungus and ingrown toenails.
• Seek medical assistance for treating open wounds.

Diabetics should receive foot checks at least once a year by a board-certified podiatrist. Frequent visits may be required for the treatment of open wounds or more chronic conditions, like peripheral neuropathy or peripheral vascular disease (osteomyelitis).

Medicare’s Therapeutic Shoe Program
This program provides one pair of diabetic shoes, and three pair of special sole inserts every year to diabetic individuals who meet eligibility requirements. Medicare will pay 80% of an approved patient's costs — the rest are usually covered by the secondary carrier. The shoes and inserts will help prevent a callus and ulcer from developing. Eligibility requirements require a medical confirmation that you have a foot ulcer, nerve function problem, reduced blood flow, previous amputation, or foot deformity, such as a hammertoe, claw toe, Charcot foot, or bunion. Prescription shoes are a safe and effective way to minimize your risk of chronic problems.

Podiatric innovations advance every day. Many of the recent innovations in wound care and operative care are bringing new hope to diabetics. Contact the Foot & Ankle Center of Illinois at 217-787-2700 if you are interested to in scheduling an appointment or to learn more about innovative foot-care treatments for diabetic patients and Medicare’s Therapeutic Shoe Program. Clinics are located in Springfield, Decatur, Taylorville, Sullivan, Shelbyville, and Carlinville. Visit myfootandanklecenter.com for more information. Back to Top