I'd like to talk to you about the diabetic foot. People
with diabetes can get complications with the foot due to excess sugar in the
blood.
One of the common ones is problems with the nerves. There are two
different sets of nerve systems in your body.
One is called the somatic system,
which controls the motor nerves to make your body move back and forth, and the
sensory nerves. And that helps you feel things. And then the other type of
system is the autonomic nervous system, and that controls the contracture of
smooth muscles and the fight and flight instincts that you have when you're
under stress. And when the sugar affects those nerves, you have decreased
function and you can get complications. Also, when you have extra sugar in your
blood, it goes onto the linings of your arteries and makes them more prone to
close down, called atherosclerosis or peripheral vascular disease. And this,
obviously having decreased circulation to your foot can be a problem.
Another
problem is that when you have decreased autonomic nerves, it changes the
ability of the capillaries to have flow. The capillaries are where the arteries
turn into veins. The very smallest vessels in your body. So that's called
microcirculation. So you get microcirculation problems as well. When you have
too much sugar in your blood it also affects the white blood cells. So that
affects your ability to heal and fight infections. When you have sores on your
feet, you're not gonna heal as fast as if you had good blood sugar. When you
have excess sugar in your body, in your blood, it affects the skin and the
nails. It makes them less healthy. You're more prone to get cuts in them,
infections like athlete's foot, and fungus toenails. We spend a lot of time work
in' on fungus toenails because having the excess fungus toenails ends up
causing more foot problems. In addition, when you have too much sugar in your
blood, it creates other issues in your body, such as problems with your kidneys.
Again, the microcirculation. Problem with your eyes. And when you have excess sugar
in your blood, you generally don't feel well and this can lead to decreased
mental happiness and satisfaction. All these things can lead to foot problems.
So when you have diabetes you have to take really good care of your feet. And
the way you do that keeps your blood sugar under excellent control, Keep your
hemoglobin A1c less than seven, preferably even lower than that. Also, no
smoking. If you smoke with diabetes, you double your chance of amputation.
So smoking just is not a good thing. We need to have a regular prevention
program for yourself. You've got to look at your feet and inspect your feet on
a regular basis. You gotta take care of your feet with gentle techniques, and I don't encourage razorblades or anything like that. And then a visit to the podiatrist
might be helpful at least annually. And he can also help you with proper shoes
and socks. So, in summary, diabetes can have a vast effect on the foot, and by proper
prevention, you can save yourself a lot of misery.
Here are some instructions about diabetic foot self-examination tips. The things that can lead to problems with diabetic feet
include progressive numbness in your feet called neuropathy. Or circulatory
changes that can make sores difficult to heal if they develop. A diabetic foot
exam is important such that you can detect problems early on in the process and
deal with them in a timely fashion so as to avoid some of the later problems
that can be catastrophic.
Now when you inspect your feet, you want to make sure that you have a good light source. You want to make sure you use corrective lenses
if needed. And you want to make sure that you evaluate each and every part of
your foot. If we look specifically at those parts, we start with the toenails
and looking around the edges of the nails in particular. In between the toes,
you want to make sure that you're not seeing any sort of cracks or fissuring
within the skin.
And then a complete exam along the bottom of your foot. Now for
some of us, it's difficult to accurately contort yourself or look at the bottom
of your foot such that you're going to get that information back. Using a mirror
can sometimes be helpful. Some mirrors may be equipped with a handle that can
make it easier for you to look and inspect the bottom of your foot accurately.
If this is not realistic for you, reaching out to friends or family to help you
inspect your feet is an important thing to consider as well.
In particular,
when you'reinspecting your feet, keep an eye out for bony prominences from one
end of the foot to the other. In particular, look for the bony areas around your
ankle, around the back or underside of your heel, and especially around the ball
of the foot and toes. These are areas that can be easily irritated just from
pressure from shoe gear, or from either lying in bed from the pressure from the
underlying mattress. As part of your foot exam, you should also make sure to inspect your shoe gear and to make sure that they're fitting you properly,
looking for signs of wear and tear with the shoes, and also to reach inside the
shoes to make sure there are no foreign objects that could cause problems for
your feet.
Now along with daily inspection of your feet, you should also keep these other things in mind. Proper foot hygiene is a must for every diabetic
patient. And you should also look to avoid walking barefoot at all times. Make
sure that the shoes that you wear fit you properly. If a problem develops, there
are different ways it may present. For example, around the toenails, sometimes
it'll be thickness, discoloration, or redness. Sometimes drainage from underneath the nail can present as an early warning sign or problem. In between the toes,
redness, fissuring, or drainage can also occur. Open wounds or thickened skin on the bottom of your foot that can be painless can also be an early sign of a
bigger problem. Your skin acts as a barrier for your entire body, including your
feet. It's important to maintain that barrier. Anytime there's a breakdown,
that's an opportunity for bacteria to get in there and cause a serious problem.
If you see any signs of skin breakdown, redness, or swelling, especially in the
absence of pain, it is extremely important that you reach out to your healthcare professional immediately.
Some diabetic foot problems can be treated
fairly quickly and easily without too much interference in one's lifestyle.
However, some problems can lead to more significant issues that can result in open sores with your feet. It can also lead to infection, hospitalization,
or in the worst-case scenario, it could result in surgery or loss of limb. So in
order to avoid this, you want to stay on top of things on a regular basis.
Hope you liked the article and from now onwards you will take care of your foot.
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