Diabetes and Feet

Diabetes and Feet
by Darlene Rempel

Over 2 million people in Canada have diabetes. Diabetes is a disease in which your body cannot properly store and use fuel for energy. Insulin, which is produced by the pancreas, essentially unlocks the cells of the body allowing in glucose from the blood for use in energy. With little or no insulin, glucose remains in the blood stream causing tiredness, hunger, weight loss, blurry vision, infections, thirst, frequent urination and moodiness. Poor management of high blood glucose levels will cause kidney failure, heart disease, impotence, blindness and potential amputation of extremities.

Type I -Diabetes is insulin-dependent or juvenile diabetes, and most often it will develop before the age of 30. There is no evidence to support the cause of developing this devastating disease.

Type II -Diabetes is not insulin dependent, and can usually be controlled with proper nutrition. The risk of type II diabetes is higher in people over the age of 45, being overweight, having diabetes in family history and having gestational diabetes during pregnancy.

Neuropathy may result with those individuals with chronic high blood sugar, wherein permanent damage will occur to the nerves. The nerves are covered by a cell particularly vulnerable to sugar in your blood, therefore high levels of blood glucose will cause nerve damage to legs, arms, hands, chest and abdomen. Nerve damage will result in a loss of sensation, pins and needles, tingling and pain. Nerve damage can also be autonomic causing damage to the bladder, stomach, intestine and sexual organs.
4 - 10% of people with diabetes will develop a foot ulcer at one time in their lives. 14 - 24% of those people will require an amputation of the lower limb as a result of an ulcer which will not heal. Diabetic feet are prone to foot ulceration because of a loss of sensation in the foot as a result of peripheral neuropathy. When the foot encounters a sharp object or blister, the nervous system sends signals to the reflexes or the brain allowing avoidance of further pain and damage to the skin. With a diabetic foot with a loss of sensation, it does not have the ability to detect this stimulus and damage occurs. Combined with slow healing and a high prevalence of a loss of sensation in the lower limb, diabetics are more prone to foot ulcerations.

Further risks for foot ulcerations include: a foot deformity, a prior history of foot ulcers, and a loss of circulation. The treatment of ulcers is most effect with recognizing and eliminating the cause. Pressure reduction is effective by changing footwear, decreasing weightbearing and the use of orthotics. Regardless of the treatment, there are some foot ulcers that just will not heal, usually because diabetics are often slow healers. There are theories that people with diabetes have defective wound healing proteins.

Some simple guidelines for foot care of a diabetic:

1. Check your feet on a regular basis for swelling, redness, broken skin, bleeding, sores, tingling and numbness.
2. Keep your feet clean. Avoid soaking your feet for prolonged periods. Check the water temperature with your elbow before putting your feet in.
3. Avoid dry skin. Keep your skin moisturized.
4. Avoid the heat and heating pads for any reason.
5. Consult with health professionals on a regular basis.
6. Avoid sharp objects on your feet. Consult with professionals for callus and corn removal.
7. Cut toe nails straight across to avoid in grown nails.
8. Maintain a healthy bodyweight. This will avoid any undue pressure on your feet.
9. Never go barefoot and before putting on shoes and slippers, check them for pebbles, sand and other objects. Check your socks, as they should not have any rough seams.
10. Kick the smoking habit because it only contributes to the already compromised circulatory system.