DIABETIC FOOT PROBLEM: SYMPTOMS,CAUSES AND TREATMENT

Hi today we are going to discuss about the different kinds of foot problems can occur in people with diabetes. There are a number of problem that a diabetic may face:

• Two main conditions are  
• Peripheral artery disease (PAD) and Peripheral neuropathy, are responsible for the increased risk of foot problems in people with diabetes.
• Symptoms and signs of diabetic foot problems arise due to the decreased sensation from nerve damage as well as the lack of oxygen delivery to the feet caused by vascular disease.
• People with diabetes have an increased risk of ulcers and damage to the feet.
• Diabetic foot problems also include bunions, corns, calluses, hammertoes, fungal infections, dryness of the skin, and ingrown toenails. These problems are not specific to diabetes, but may occur more commonly due to the nerve and vascular damage caused by diabetes.
• Treatment depends on the exact type of foot problem. Surgery or even amputation may be required for some cases.
• Gangrene (dry gangrene) is tissue death due to absence of blood circulation. It can be life threatening if bacterial infection develops (wet gangrene).
• Many diabetes-related foot problems can be prevented by good control of blood sugar levels combined with appropriate care of the feet.

How can diabetes cause foot problems?

Both type 1 and type 2 diabetes cause damage to blood vessels and peripheral nerves that can result in problems in the legs and feet. Two main conditions, 1) peripheral artery disease (PAD), and 2) peripheral neuropathy are responsible for the increased risk of foot problems in people with diabetes.

• Peripheral artery disease (PAD), sometimes referred to as peripheral vascular disease (PVD), means that there is narrowing or occlusion by atherosclerotic plaques of arteries outside of the heart and brain. This is sometimes referred to as "hardening" of the arteries. Diabetes is a known risk factor for developing peripheral artery disease. In addition to pain in the calves during exercise (medically known as intermittent claudication), the signs and symptoms of peripheral artery disease relate to a decreased delivery of oxygen to the lower legs and feet. In severe cases, the lack of oxygen delivery to tissues can result in ulcers and even gangrene (tissue death).
• Peripheral neuropathy refers to damage to the peripheral nerves directly as a result of diabetes. Symptoms of peripheral neuropathy include decreased sensation in the nerves of the legs and feet, making it difficult to perceive injuries due to lack of feeling. Peripheral neuropathy also causes a tingling, pain, or burning in the involved areas. It can also cause the muscles of the feet to work improperly, leading to misalignment of the foot that can put pressure on certain areas of the foot.

Peripheral Artery Disease (PAD or PVD) Symptoms

Peripheral artery disease (or peripheral vascular disease) symptoms include:

·        Intermittent claudication

·        Numbness in the extremities

·        Weakness of the calf muscle

·        Pain at rest

·        Hair loss

·        Coldness in the legs or feet

What are the symptoms of foot problems caused by diabetes?

In the most severe case, as mentioned above, due to a combination of decreased sensation and reduced blood flow to the feet, ulcers may develop. If the tissues continue to receive insufficient oxygen, tissue death (gangrene) occurs. Gangrene is a serious and potentially life-threatening condition. Other potentially serious problems that may develop include cellulitis (infection of the tissues beneath the skin) and osteomyelitis (infection of the bone); sepsis (the infection spreads to the bloodstream) also is possible.

People with diabetes are at increased risk for milder problems with the feet that are not specific to diabetes but may occur more frequently due to problems with the nerves and circulation to the feet.

Some of these conditions are:

Calluses and corns, that may develop due to abnormal alignment of the feet or abnormal gait

• Fungal infections of the nails, which can appear as thickened, discolored, and at times brittle nails
• Tinea pedis, or athlete's foot, a fungal infection of the skin of the feet
• Hammertoes, or bent toes due to muscle weakness.
• Bunions, or the angling of the big toe toward the second toe. The area of the bunion may become reddened and irritated, leading to callus formation.
• Ingrown toenails
• Cracking of the skin of the feet, especially the heels, due to dry skin

How are foot problems caused by diabetes treated?

Treatment depends upon the type of foot problem. For example, some problems such as corns may require wearing corrective shoes, while others such as mild infections may be treated with antibiotics or antifungals. Other problems may need surgical debridement and antibiotics. Gangrene, or tissue death, cannot be reversed, but treatments are available to prevent gangrene (often termed dry gangrene) from spreading or becoming infected (dry gangrene becomes infected and develops into wet gangrene). Surgical removal of the dead tissue is typically required, and antibiotics are given to prevent the development of life-threatening infections in the dead tissue. In severe cases of gangrene, amputation of the affected part may be necessary.

Other types of foot problems can be relieved by proper footwear, sometimes with orthotic devices, and splinting or bracing. For some conditions like hammertoes, bunions, and ingrown toenails; surgery may be necessary to correct severe cases.

Taking proper care of your feet (see Prevention section) can help prevent or relieve many common foot problems in people with diabetes.

Can diabetes-related foot problems be prevented?

Some diabetes foot-related problems can be prevented by taking careful steps to observe and care for your feet. Keeping blood sugar levels under control (in the ranges advised by your doctor), and following your recommended diet and exercise program are the best way to prevent all complications of diabetes, including foot problems. In addition to keeping your diabetes under control, you can take steps to care for your feet, including the following:

• Wear comfortable, closed-toe footwear at all times. Special shoes are available for people with bunions or foot deformities if these are necessary. Be sure no objects are trapped inside the shoes that could cut or injure your feet.
• Don't walk barefoot, even at home. Be sure your feet do not get burned by walking on very hot pavement in summer
• Always wash your feet with warm water and dry them well after washing.
• Check your feet daily for any sores or problems.
• Apply lotion to dry areas, especially heels, but don't use lotion between the toes. Corns and calluses can be lightly smoothed with a pumice stone. Never use scissors or razors to cut away corns or calluses.
• Trim toenails straight across, and do not cut the corners shorter than the rest of the nail.
• Be sure that your doctor checks your feet at every checkup.
• Stop smoking, if you are a smoker. Smoking further increases the risk of arteriosclerosis and poor circulation to the feet.

If left with any doubt or query you can comment in the comment section below.

10 Shocking Facts About Causes Of Diabetes.

Hi, today we will be discussing about the causes of diabetes and what are some of the reasons due to which some of the people are made to face this disease.

Firstly, even before we discuss about what are the causes of diabetes we must know that what are the symptoms that are there when you are a diabetic. If there is any of the symptoms listed below then you should take it seriously and should not ignore it. You should immediately consult to your doctor.

What are the symptoms of diabetes?

              

Symptoms of diabetes include

·        increased thirst and urination

·        increased hunger

·        fatigue

·        blurred vision

·        numbness or tingling in the feet or hands

·        sores that do not heal

·        unexplained weight loss

Symptoms of type 1 diabetes can start quickly, in a matter of weeks. Symptoms of type 2 diabetes often develop slowly—over the course of several years—and can be so mild that you might not even notice them. Many people with type 2 diabetes have no symptoms. Some people do not find out they have the disease until they have diabetes-related health problems, such as blurred vision or heart trouble.

What causes type 1 diabetes?

                       

Type 1 diabetes occurs when your immune system, the body’s system for fighting infection, attacks and destroys the insulin-producing beta cells of the pancreas. Scientists think type 1 diabetes is caused by genes and environmental factors, such as viruses, that might trigger the disease. Studies such as TrialNet are working to pinpoint causes of type 1 diabetes and possible ways to prevent or slow the disease.

What causes type 2 diabetes?

                            

In contrast to the uncertainty surrounding Type 1 diabetes, there are clear risk factors for Type 2 Diabetes:

Advancing Age. All people are at increased risk for developing Type 2 diabetes as they age. While type Type 2 diabetes can occur in people of any age, it is much more common in people aged 40 or older.  Although recent evidence suggests that more and more children are falling victim to type 2 diabetes.  The American Diabetes Association reports that roughly one in six overweight children falls into the pre-diabetic category.  Many of these pre-diabetic children will go on to develop full blown type 2 diabetes.

                                            

Race and Ethnicity. Type 2 diabetes occurs more commonly among certain ethnic groups than others. African Americans, Native Americans, Hispanic Americans, Pacific Islander, and Asian American are at greater risk for developing the illness than are Caucasians.

Family History of Diabetes. People who have close blood relatives (siblings or parents) who have diabetes are at increased risk of getting diabetes themselves compared to people who do not have a blood relative with the disease.

                                             

Personal History of Gestational Diabetes or High Birth Weight Baby. Mothers who experienced temporary Gestational diabetes during pregnancy, or who gave birth to a high birth weight baby (9 lbs or larger) are at increased risk for developing Type 2 diabetes.

Pre-diabetes. Pre-diabetes, otherwise known as “impaired glucose tolerance”, is a pre-cursor to Type 2 diabetes. A pre-diabetic person's blood sugar levels are higher than normal, but not yet as high as is necessary for a diagnosis of diabetes. As the name suggests, pre-diabetes is considered to be a station along the way towards full blown Type 2 diabetes. Without intervention, many pre-diabetic people go on to develop Type 2 diabetes within a decade. Many people who develop pre-diabetes are overweight, have poor diets and live sedentary (inactive) lifestyles. Pre-diabetes can often be reversed with proper self-care including regular exercise and a healthy diet.

Sedentary Lifestyle. People who lead sedentary, inactive lives (e.g., who work at a desk job and then watch a lot of TV) have a greater risk of developing diabetes than more active people (e.g., who have built regular exercise into their daily routines). Even modest exercise, (30 minutes a day, three days a week) has been shown to significantly decrease Type 2 diabetes risks. Adopting and sticking to a regular exercise program can often help to reduce Type 2 diabetes symptoms.

Diet and Obesity. The majority of people diagnosed with Type 2 diabetes are overweight adults. Research has demonstrated that modest sustained weight loss (of even 10 lbs), portion control, and lower-fat and refined sugar dietary choices reduce Type 2 diabetes risk. A lower-fat diet, proportionally balanced among the food groups, and featuring more natural foods such as fresh fruits and vegetables is best for this purpose. In combination with regular modest exercise, the health-promoting effects are even larger.

History of Cardiovascular Disease. High blood cholesterol and hypertension (high blood pressure) are also risk factors for Type 2 diabetes. Luckily, both of these conditions can usually be prevented by eating a healthy diet and getting regular exercise. Medicines are also available for people with hypertension or high blood cholesterol who can not control the conditions with diet and exercise alone.

The more of these risk factors you have in your life, the greater your chances for getting Type 2 diabetes. The best way to prevent Type 2 diabetes is to eliminate as many of the controllable risk factors for the illness as possible from your life.

What causes gestational diabetes?

                         

Scientists believe gestational diabetes, a type of diabetes that develops during pregnancy, is caused by the hormonal changes of pregnancy along with genetic and lifestyle factors.

Insulin resistance

Hormones produced by the placenta contribute to insulin resistance, which occurs in all women during late pregnancy. Most pregnant women can produce enough insulin to overcome insulin resistance, but some cannot. Gestational diabetes occurs when the pancreas can’t make enough insulin.

As with type 2 diabetes, extra weight is linked to gestational diabetes. Women who are overweight or obese may already have insulin resistance when they become pregnant. Gaining too much weight during pregnancy may also be a factor.

Hormonal changes, extra weight, and family history can contribute to gestational diabetes.

Genes and family history

Having a family history of diabetes makes it more likely that a woman will develop gestational diabetes, which suggests that genes play a role. Genes may also explain why the disorder occurs more often in African Americans, American Indians, Asians, and Hispanics/Latinas.

What else can cause diabetes?

Genetic mutations  and other diseases, damage to the pancreas, and certain medicines may also cause diabetes.

Genetic mutations

·        Monogenic diabetes is caused by mutations, or changes, in a single gene. These changes are usually passed through families, but sometimes the gene mutation happens on its own. Most of these gene mutations cause diabetes by making the pancreas less able to make insulin. The most common types of monogenic diabetes are neonatal diabetes and maturity-onset diabetes of the young (MODY). Neonatal diabetes occurs in the first 6 months of life. Doctors usually diagnose MODY during adolescence or early adulthood, but sometimes the disease is not diagnosed until later in life.

·        Cystic fibrosis produces thick mucus that causes scarring in the pancreas. This scarring can prevent the pancreas from making enough insulin.

·        Hemochromatosis causes the body to store too much iron. If the disease is not treated, iron can build up in and damage the pancreas and other organs.

Hormonal diseases

                              

Some hormonal diseases cause the body to produce too much of certain hormones, which sometimes cause insulin resistance and diabetes.

·        Cushing’s syndrome occurs when the body produces too much cortisol—often called the “stress hormone.”

·        Acromegaly occurs when the body produces too much growth hormone.

·        Hyperthyroidism occurs when the thyroid gland produces too much thyroid hormone.

Damage to or removal of the pancreas

Pancreatitis, pancreatic cancer, and trauma can all harm the beta cells or make them less able to produce insulin, resulting in diabetes. If the damaged pancreas is removed, diabetes will occur due to the loss of the beta cells.

Medicines

                     

Sometimes certain medicines can harm beta cells or disrupt the way insulin works. These include

·        niacin, a type of vitamin B3

·        certain types of diuretics, also called water pills

·        anti-seizure drugs

·        psychiatric drugs

·        drugs to treat human immunodeficiency virus (HIV )

·        pentamidine, a drug used to treat a type of pneumonia 

·        glucocorticoids—medicines used to treat inflammatory illnesses such as rheumatoid arthritis, asthma, lupus, and ulcerative colitis

·        anti-rejection medicines, used to help stop the body from rejecting a transplanted organ

Statins, which are medicines to reduce LDL (“bad”) cholesterol levels, can slightly increase the chance that you’ll develop diabetes. However, statins help protect you from heart disease and stroke. For this reason, the strong benefits of taking statins outweigh the small chance that you could develop diabetes.

If you take any of these medicines and are concerned about their side effects, talk with your doctor.

So I think I have listed almost all the causes of diabetes

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