Diabetes is a disease where the body cannot produce insulin or cannot use it effectively. Insulin is the hormone that is responsible for helping the cells take in sugar to use for energy. When this does not happen properly, the levels of sugar in the blood can become too high.

Prolonged periods of high sugar levels in the blood can wreak havoc on many areas of the body, including the feet.

Diabetic foot problems

The two main foot problems that affect people with diabetes are:

Diabetic neuropathy

Over time, diabetes can cause nerve damage that makes it hard for people with diabetes to feel sensation in their extremities.

The condition also makes it difficult for a person to feel an irritation on their foot or notice when their shoes are rubbing. This lack of sensation and awareness leads to an increase in the risk of cuts, sores, and blisters developing.

Peripheral vascular disease

Diabetes leads to changes in the blood vessels, including arteries. In peripheral vascular disease, fatty deposits block these vessels beyond the brain and heart. It tends to affect the blood vessels leading to and from the extremities, reducing blood flow to the hands and feet.

Reduced blood flow can lead to pain, infection, and slow healing wounds. Severe infections may lead to amputation.

Symptoms

Symptoms may vary from person to person and may depend on what issues a person is experiencing at the time. Symptoms of diabetic foot problems can include the following:

• loss of feeling
• numbness or tingling sensation
• blisters or other wounds without painful
• skin discoloration
• skin temperature changes
• red streaks
• wounds with or without drainage
• painful tingling
• staining on socks
• deformed foot appearance

If an infection is present in a foot or foot ulcer, a person may also experience some of the following:

• fever
• chills
• uncontrollable blood sugar
• shaking
• shock
• redness

Anyone who experiences any of the symptoms of an infection should seek emergency treatment.

Complications

Diabetic neuropathy and peripheral vascular disease are serious conditions that must be monitored closely. Both cause complications that can have serious negative effects. These complications may include:

• foot ulcers, or wounds, that do not heal
• infections, including skin infections, bone infections, and abscesses
• gangrene, when an infection causes tissue death
• foot deformity
• Charcot’s Foot (fractures or dislocations in the foot that may cause deformities)
  

  Treatment

  Treatment for diabetic foot problems varies according to the severity of the condition. A range of surgical and nonsurgical options is available.

  Nonsurgical treatment

  Nonsurgical options are normally the first method of treatment for diabetic foot problems. Some of these include:

  • keeping wounds clean and dressed
  • immobilization devices, such as a cast boot or total contact cast
  • close observation of gangrene toes until self-amputation occurs, when the toes fall off due to lack of blood flow

  Surgical treatment

  When nonsurgical treatment fails to heal diabetic foot problems, surgery may be considered. Surgical treatment options include:

  • removal of decaying or dead tissue
  • amputation, varying from toe or part of the foot to amputation of the leg below the knee, or above the knee in some cases
  • surgical stabilization of Charcot’s Foot
  • arterial bypass for peripheral vascular disease, or endovascular surgery with placement of stents