Though they can easily be overlooked, feet are especially at risk of serious complications relating to diabetes. Staying informed about symptoms and preventative care is crucial to treating foot diseases that could arise, according to John Giurini, DPM, Chief of Podiatric Surgery at Beth Israel Deaconess Medical Center (BIDMC). Here’s what he says you should know about complications you may encounter, and how the BIDMC team has the tools to help mitigate them.
Diabetes is a serious disease that affects various parts of your body. In your feet, it can lead to nerve damage and cause a loss of sensation. It can also make it difficult for injuries to heal by affecting the blood supply to your feet.
Diabetic neuropathy is one of the most common complications of diabetes and can present itself in a few different forms. The first is a lack of sensation in the foot, making it difficult to feel any sores, blisters, or injuries, even if you’ve stepped on something sharp.
Another form of neuropathy occurs when the nerves that control muscle function are affected. These patients will have trouble walking and may develop what is referred to as a “drop foot” that makes tripping or falling more common.
The third form of neuropathy is called neuritis, or painful neuropathy. These patients have constant foot pain throughout the day, and in more severe forms, it can keep them awake at night. Patients are typically referred to BIDMC’s Arnold-Warfield Pain Center to help treat this type of neuropathy.
Peripheral vascular disease is the narrowing of arteries, which affects the blood flow to limbs. Blood flow is important for bringing nutrients such as oxygen and growth factors to the foot to allow sores to heal. With poor circulation, sores and cuts heal more slowly. This condition is often found in patients with diabetes because diabetes-related nerve damage can make it difficult to diagnose. These patients are typically referred to BIDMC’s Division of Vascular and Endovascular Surgery for evaluation and treatment.
The earlier you catch a problem, the easier it is to treat. It’s important for patients with diabetes to get into the habit of regularly inspecting their feet. The best time is immediately after a shower while drying your feet, or at the end of the day when removing socks and shoes. If you see a blister, it’s important to get it off the foot completely. Put a clean dressing with some type of antiseptic on it, and contact your podiatrist or physician.
Another good habit is to inspect your shoes before putting them on. Many times things get inside shoes — rocks, pebbles, etc. — that can cause foot irritation. With a lack of sensation, you may not be able to feel these objects.
Finally, high-risk patients should be seen by a foot care specialist every three months. High-risk patients include those with abnormal sensation or circulation and those with foot deformities. Many of these problems can be prevented by controlling your diabetes and inspecting the feet regularly.
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