At Peninsula Podiatry, our podiatrists are skilled in diabetic foot care and can help patients with the treatment and prevention of foot problems associated with diabetes.
Diabetes affects all body systems. In the feet, it can limit your blood flow, decrease your nerve sensation and cause delayed healing to cuts and blisters, resulting in foot wounds. Commonly, patients end up with these wounds as a result of attempting to trim their own toenails and calluses.
If these patients lose feeling in the feet, coupled with poor circulation, it can also lead to very serious infections.
Diabetic patients may experience chronic nerve damage called neuropathy, which often results in loss of feeling in the feet. These patients often do not feel trauma or irritation of the foot, so many wounds are not discovered or treated right away.
Neuropathy can also cause the skin to become very dry and cracked, allowing infection-causing bacteria to enter. Diabetic patients also have poor blood circulation, which can lead to the development of ulcers in the feet.
In diabetic patients, small wounds like ulcers and cracked skin can develop into very serious infections if left untreated. These infections can be very difficult to treat due to poor blood supply–the blood cannot adequately deliver antibiotics to the wound site. Thus, many diabetic wounds are difficult to heal.
Because it is difficult to treat infections in diabetic patients, it is important to get treatment as soon as possible to avoid potential complications. Even if a wound seems minor or is not painful, it can still lead to a very serious infection.
Diabetes makes you especially susceptible to foot wounds that have delayed healing. These wounds, known as ulcers, can be dangerous and lead to significant infections and possible amputations if allowed to persist too long.
Serious infections in the feet can lead to hospitalization. There are often several facets to treating a diabetic wound. Our team may need to clean out and remove any dead or infected tissue. Antibiotics are also administered to help clear up the infection. A vascular surgery evaluation may also be recommended.
If the infection is unable to be cleared up through antibiotics and cleaning out diseased tissues, amputation is often necessary. This is unfortunately very common for diabetic patients, as poor blood circulation makes it difficult to heal infections in the feet.
Unfortunately, diabetic patients who have had a foot or leg amputation have a very high risk of having the opposite foot or leg amputated within 5 years. Furthermore, there is a very high 5-year mortality rate associated with amputations in diabetic patients.
To avoid serious complications, it is important that diabetic patients take good care of their feet.
Preventative care is extremely important for diabetic patients. We recommend the following to patients to avoid serious complications.
General Foot Care
Never walk barefoot, as diabetic nerve damage (neuropathy) lessens your ability to feel pain, heat, and cold, so you may not notice that little pebbles or objects have gotten stuck in your foot. Always wear shoes or slippers to reduce your risk of infection.
Inspect Feet Daily
Patients should inspect their feet daily to look for wounds, as well as redness, warmth, bruising, blisters, and nail problems. Patients should use a mirror to look at the bottom of the feet. Any abnormalities should be treated right away to avoid complications. Patients should also look for swelling because that is an early sign of Charcot arthropathy. Charcot arthropathy can cause the foot to become deformed and may lead to disability.
Practice Daily Foot Care
Diabetic patients should clean their feet daily with warm water and mild soap. However, patients should not soak their feet, as it can dry out the skin. After washing, carefully pat the feet dry with a towel, taking care to eliminate all moisture while avoiding vigorous rubbing. Unscented lotion should be applied after washing to lock in moisture and prevent dry skin. However, avoid putting creams and lotions between the toes, as the extra moisture can lead to an infection.
Toenails should be trimmed straight across. Avoid cutting corners to prevent ingrown toenails. If present, ingrown toenails should be treated right away to reduce the risk of infection. Patients should wear socks at night and during cold weather to keep the feet warm.
While not technically foot care, it is also important that diabetic patients avoid smoking. Smoking damages the blood vessels, which, combined with diabetic nerve damage and poor circulation, can significantly increase your chances of amputation in the future.
Wear Appropriate Shoes and Orthotics
Patients should choose shoes that are comfortable and well-fitted. Avoid shoes that are too tight or small, as well as shoes with pointed toes and high heels. Custom orthotics and even custom footwear can help to accommodate foot deformities and provide relief from neuropathy and poor vasculature.
Regular foot care is extremely important for diabetic patients. Our podiatrists are available to help with all of your diabetic foot care needs, including nail care, callus care, and yearly diabetic foot exams. If you would like to schedule an appointment with Peninsula Podiatry for Diabetic Foot Care, please call (360) 443-5632.
