How Diabetes Affects the Feet: Understanding the Risks and Prevention Strategies

Diabetes is a chronic condition that affects millions of people worldwide, and one of its most significant complications is the impact it has on the feet. Diabetic foot problems can range from minor issues like fungal infections to severe complications such as ulcers and amputations. Understanding how diabetes affects the feet and implementing proper care strategies can significantly reduce the risk of these complications.

Introduction to Diabetic Foot Problems

Diabetes can cause two primary issues that affect the feet: diabetic neuropathy and peripheral vascular disease.

• Diabetic Neuropathy: This condition occurs when diabetes damages the nerves in the legs and feet. As a result, individuals may lose sensation in these areas, making it difficult to detect injuries such as cuts or blisters. Without proper care, these injuries can become infected and lead to serious complications.
• Peripheral Vascular Disease: Diabetes also affects blood flow, leading to reduced circulation in the feet. This poor blood flow slows down the healing process of wounds, increasing the risk of infections and ulcers.

Common Foot Problems in Diabetes

People with diabetes are more susceptible to common foot issues that can escalate into serious complications:

1. Athlete's Foot: A fungal infection causing itching, redness, and skin cracking. It can be treated with antifungal medications but requires careful management to prevent infection.
2. Fungal Infections of the Nails: These infections can lead to discolored, thickened, or brittle nails. The warm environment inside shoes fosters fungal growth, and injuries can increase the risk of infection.
3. Skin and Bone Infections: Small cuts can lead to infections, especially with nerve and blood vessel damage. These infections can be treated with antibiotics but may require hospitalization in severe cases.
4. Abscesses: Infections can create abscesses, which are pockets of pus that may require drainage or surgical intervention.
5. Gangrene: Reduced blood flow can cause tissue death, leading to gangrene. Treatment often involves oxygen therapy or surgical removal of affected tissue.

Complications of Diabetic Foot Problems

The most severe complication of diabetic foot problems is amputation. Foot ulcers that do not heal can lead to infections that spread, necessitating the removal of toes, feet, or parts of the leg to prevent further complications.

Prevention Strategies

Preventing diabetic foot complications involves a combination of good diabetes management and regular foot care:

1. Manage Diabetes: Keeping blood sugar levels under control is crucial. This includes following a healthy diet, exercising regularly, monitoring blood sugar levels, and taking medications as prescribed.
2. Regular Foot Care:
• Wash feet daily in lukewarm water and dry them thoroughly, especially between the toes.
• Use talcum powder or cornstarch to keep skin dry.
• Apply moisturizer to prevent dry skin cracks.
• Wear properly fitting shoes that provide support and cushioning.
3. Screening and Monitoring: Annual foot exams are recommended for all people with diabetes. Those at higher risk should be screened more frequently for loss of sensation and peripheral artery disease5.
4. Education and Awareness: Educating individuals with diabetes about proper foot self-care and the importance of seeking medical attention early for any foot issues is vital.
5. Therapeutic Footwear: Wearing shoes designed to reduce pressure on the feet can help prevent ulcers. These shoes should be prescribed by healthcare professionals.

Conclusion

Diabetes can significantly impact the feet, leading to serious complications if not managed properly. By understanding the risks and implementing effective prevention strategies, individuals with diabetes can reduce their likelihood of developing severe foot problems. Regular foot care, good diabetes management, and early intervention are key to maintaining healthy feet and preventing amputations.

Dr. Praveen Kumar N S
MBBS, MD (Gen. Med.), DNB (Endocrinology)
Consultant Endocrinologist & Diabetologist
Dr. Praveen's Endocrine Centre

Mysuru, Karnataka. 570009.

References

1. WebMD: Diabetic Foot Problems: Symptoms, Treatment, and Care
2. Mayo Clinic: Amputation and diabetes: How to protect your feet
3. International Working Group on the Diabetic Foot (IWGDF): Guidelines on the prevention and management of diabetic foot disease
4. Diabetes Journal: Etiology, Epidemiology, and Disparities in the Burden of Diabetic Foot Ulcers
5. Diabetes/Metabolism Research and Reviews: Guidelines on the prevention of foot ulcers in persons with diabetes
6. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK): Foot Problems
7. WebMD: Diabetes Foot Care: Tips for Healthy Feet