Definition & Overview

The Center for Disease Control (CDC) has confirmed that in 2014, 29.1 million people, or 9.1% of the United States population had diabetes and that 8.1 million of these people were undiagnosed. Diabetes is a disease that has a wide variety of complications. One of these is a condition called the diabetic foot, which is the result of the two common complications of diabetes: reduced blood flow and nerve damage. While nerve damage results in diminished sensation in the feet, reduced blood flow results in the formation of cracks in the skin that allow bacteria to enter and cause an infection. The condition is a major health concern, which often results in hospitalization.

People who have been diagnosed with diabetic foot require antibiotics to control the infection. If the infection can no longer be controlled, the affected foot will be amputated to prevent the infection from spreading to the rest of the body.

Managing diabetes while it is still in its early stages is the best way to prevent the development of diabetic foot. It also helps to take good care of the feet to prevent bacteria and infections as well as avoiding foot injuries at all cost, because even a small cut can have drastic consequences.

Cause of Condition

The complications of diabetes, such as peripheral neuropathy (loss of sensation), arterial insufficiency (poor blood flow), impaired resistance to infections, trauma, and foot deformity, are the common causes of diabetic foot condition. The complications result in the formation of calluses on the feet, which turn into ulcers.

Ulcers often appear on the ball of the foot or underneath the big toe. They can also appear on the sides of the feet, but these are mostly caused by improper shoe fitting.

It’s important to realize that ulcers are a cause for concern, even if they don’t hurt. It is best to consult your doctor or a diabetes specialist to receive treatment for an ulcer. Do not attempt to self medicate as doing so may cause the ulcer to worsen and become infected, making foot infections more difficult to treat.

Because calluses often cause foot ulcers, it’s best to manage the calluses properly when or if they form. Calluses are best kept under control by using pumice stones. Do not try to cut the calluses or use chemicals to remove them. After every session with pumice stone, make sure that you apply lotion to moisturize the area to prevent the development of cracks and prevent bacteria from entering the skin. In fact, since diabetes often causes dry skin, it’s best to use moisturizing lotion on a daily basis.

Every diabetic has a high risk of developing the condition, which is why it’s imperative that the diabetes is controlled as much as possible. If you take care of your feet and manage problems as soon as they arise, you’ll reduce the risk of a diabetic foot condition, infections, and amputation.

Key Symptoms

Diabetic foot will normally present itself as cellulitis, deep skin infections, acute osteomyelitis, or chronic osteomyelitis. Each form has different symptoms.

The primary characteristics of cellulitis are tender non-raised skin lesions. The condition is often not accompanied by wounds or ulcers.

Deep skin infections result in extreme pain and a foul discharge.

Diabetics with acute osteomyelitis will experience fever and pain at the site.

Those with chronic osteomyelitis may or may not experience pain but will usually have deep penetrating ulcers between the toes or on the plantar surface of the foot.

Since diabetic foot presents itself in different forms, the treatment for the condition will depend on the form and its severity.

Who to See & Types of Treatment Available

If you’ve been diagnosed with diabetes, the first person to see is your family doctor, a general practitioner, and depending on the severity of your condition, a diabetes specialist.

Treatment for diabetic foot that is caused by cellulitis will usually include antibiotics, while treatment for deep skin infections will be a combination of medications and the removal of infected skin tissues.

Treatment for acute osteomyelitis for patients with diabetes is often similar to the treatment of the condition for patients without diabetes and this typically includes antimicrobial therapy. Meanwhile, chronic osteomyelitis is managed through the surgical removal of infected tissues and a variety of antibiotics. The final option for patients with this condition is the amputation of the infected foot.

Just like with other medical condition, however, prevention is much better than cure. The prevention of diabetic foot can be achieved by properly managing diabetes. If you’ve been diagnosed with the condition, certain lifestyle changes will be required not just to manage the condition but also avoid its complications. Exercising on a regular basis, eating healthy diet, and avoiding smoking and drinking, for example, can significantly increase your chances of avoiding diabetic foot.

Aside from lifestyle changes, you’ll also need to check your feet every day, especially if you notice a loss of sensation. It’s easy for a small wound to go unnoticed and when left treated, it will result in an infection. Washing and moisturizing the feet as well as properly removing corns and calluses help protect feet from the elements. Trimming toenails regularly, wearing shoes and socks all the time, and making sure that the shoes are not too tight will also make a huge difference.

Meanwhile, massaging the legs on a regular basis helps ensure normal blood flow to the feet. It’s best to avoid sitting down for long periods as taking short walks or keeping active as long as possible not only helps your body fight diabetes, but also ensures that the blood flow in your feet remains constant.

References:

  • American Diabetes Association. Standards of medical care in diabetes -- 2014. Diabetes Care. 2014;37 Suppl 1:S14-S80.
  • Bril V, England J, Franklin GM, et al. Evidence-based guideline: Treatment of painful diabetic neuropathy: report of the American Academy of Neurology, the American Association of Neuromuscular and Electrodiagnostic Medicine, and the American Academy of Physical Medicine and Rehabilitation. Neurology. 2011;76:1758-1765.
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