Diabetes Complications

Diabetic Foot Pain: Symptoms, Treatment, and Care

Diabetes is a common disease that many people develop during their lifetime.

While many people know that diabetes is bad for them, not many know of all the complications diabetes can cause.

In addition to affecting your blood sugar and eating habits, diabetes can also cause foot problems.

If you have been diagnosed with diabetes, then you now must pay much more attention to your feet.

Without proper care, diabetic foot problems can occur, resulting in injury an in extreme cases, even amputation. Even minor foot problems can become a big deal if you have diabetes.

Let’s learn more about the complications, symptoms, and treatments for diabetics’ feet. Diabetic neuropathy and peripheral vascular disease are the two main foot problems that occur, and both can have serious complications.

Foot Problems in Diabetes

Diabetic neuropathy

Over time, diabetic neuropathy can result in nerve damage. Diabetes can cause many complications throughout the body, but especially in the feet. The main complication is that high blood sugar can cause neuropathy.

Neuropathy is a type of nerve damage that can happen anywhere in the body. However, it is most common in the legs and feet of people with diabetes . Diabetes leads to changes in the blood vessels, including arteries, which can result in poor blood circulation.

Peripheral vascular disease

In peripheral vascular disease, fatty deposits block vessels beyond the brain and heart.

This means you cannot properly fight infections or feel warmth in your feet. You may also feel pain in your feet and shins when walking. Your feet will also swell if circulation is poor.

Reduced blood flow can lead to pain, infection, and wounds that heal slowly. If a person develops a severe infection, a doctor may recommend amputation.

Diabetes can also affect the skin on your feet. The skin can become very dry and crack very easily.

Symptoms of Diabetic Foot Pain

People who have diabetes should see a doctor regularly as part of their care.

However, anyone who notices any of the following changes should seek immediate medical attention:

  • variations in skin color on the foot

  • swelling in the foot or ankle 

  • temperature changes in the feet 

  • persistent sores on the feet 

  • pain or tingling in the feet or ankles 

  • ingrown toenails

  • athlete’s foot or other fungal infections of the feet 

  • dry, cracked skin on the heels 

  • signs of infection

Complications

Signs of infection include redness and warmth around the sore. You may also begin to see the breakdown of skin and the tissue beneath it. There may also be swelling, and your shoes may no longer fit. Neuropathy can also change the way your feet and toes are shaped.

Corns or calluses also develop much more quickly on diabetic feet. If calluses are not properly treated, they can become ulcers. Foot ulcers are a huge problem for people with diabetes because they can lead to infection and amputation.

A further complication of diabetes that can occur is Charcot’s foot. This alters the shape of the feet as bones in the foot and toe-shift or break.

Neuropathy can hurt so that you may feel tingling or a burning sensation in your feet. However, with advanced neuropathy, you will not feel anything at all.

This is especially dangerous because your feet will no longer feel pain as they once did. You may not be aware that you have a blister, bruise, corns or calluses or scrape on your foot.

This can quickly lead to an open sore, or ulcer. If the sores go untreated, they can become infected.

Treatment for Foot Problems

Practicing diabetic foot care is essential. Your doctor should examine your feet every time you go in for a checkup. They can help you check for any changes in your feet.

Even a seemingly harmless infection like athlete’s foot can cause problems, so ask your doctor to thoroughly inspect your feet and show you how to do it at home.

Nonsurgical treatment

A doctor will first attempt to treat diabetic foot problems without using surgery. Some methods include:

  • If you develop an ulcer, your doctor will probably recommend a special boot or cast to help take the pressure off of your foot. This will help the ulcer heal more quickly. It will also be important for you to stay off of your feet as much as possible.

  • keeping wounds clean and dressed

  • closely observing any gangrene on the toes until self-amputation occurs, which is when the toes fall off due to lack of blood flow

  • If neuropathy has caused your feet to change shape, you may need to invest in special shoes to accommodate your newly shaped feet.

Surgical treatment

When nonsurgical treatment does not successfully heal diabetic foot problems, the doctor might consider surgery. Surgical options include:

  • the removal of dead tissue

  • depending on the severity of the infection, you may need to spend some time in the hospital. If the infection spreads to the bones, your foot may need to be amputated.

  • surgical stabilization of Charcot’s Foot

  • an arterial bypass for peripheral vascular disease. This assists blood flow to the area

  • surgery with placement of stents, to keep blood vessels open

Why Foot Care is Important

The best way to avoid severe foot complications from diabetes is to take care of your feet daily. Check your feet every day before you wash them in lukewarm water. (Hot water can damage your feet further and dry your skin out).

Carefully dry your feet with a clean towel and make sure the skin between your toes is dry. Apply a thin layer of lotion to the tops and bottoms of your feet, avoiding the area between the toes.

Make sure you always wear comfortable shoes and socks and never go barefoot. Thoroughly inspect your shoes and replace them when they show signs of wear.

You should also throw away any socks that have holes and avoid socks that have seams that may rub your feet.

When to see a doctor

 If you notice any of the following changes should seek immediate medical attention:

  • changes in skin color

  • swelling in the foot or ankle

  • temperature changes

  • sores and signs of infection

  • pain or tingling sensation

  • ingrowing toenails

  • fungal infections of the feet

  • dry, cracked skin

Tips’ for Prevention

In addition to practicing healthy lifestyle habits and taking steps to manage blood sugars, other things may help reduce the risk of developing nerve or artery problems from diabetes. Some healthy habits to adopt include:

  • Practicing good foot care techniques: inspecting the feet each day for calluses and other changes can help identify problems early and lead to a quicker resolution to prevent complications.

  • Treating wounds on the legs and feet promptly, seeking professional medical advice whenever warranted.

  • Exercising regularly.

  • Stopping smoking.

  • Keeping blood pressure under control; ask your doctor what your individual blood pressure target numbers are.

  • Working to keep cholesterol levels at a healthy level, increased cholesterol levels can be a risk factor for arterial disease, which can lead to pain in the legs.

  • Avoiding alcohol.

Conclusion

If you have diabetes, then it is incredibly important to take care of your feet. Neuropathy and poor circulation can make feeling and fighting any infection in your feet difficult.

Severe ulcers can form from small cuts or infections and can lead to amputation. Diabetics have the highest risk of foot amputation.

By being very diligent with your foot care, you can avoid many of these complications and keep your feet healthy and happy.

You can also prevent foot complications by regularly exercising and following a proper diet that will keep your blood sugar levels low and stable. Always remember that feet come first for people with diabetes!

Sources

  1. Fawzy MS, Alshammari MA, Alruwaili AA, et al. Factors associated with diabetic foot among type 2 diabetes in Northern area of Saudi Arabia: a descriptive study. BMC Res Notes. 2019;12(1):51. Published 2019 Jan 22. doi:10.1186/s13104-019-4088-4
  2. Yazdanpanah L, Shahbazian H, Nazari I, et al. Incidence and Risk Factors of Diabetic Foot Ulcer: A Population-Based Diabetic Foot Cohort (ADFC Study)-Two-Year Follow-Up Study. Int J Endocrinol. 2018;2018:7631659. Published 2018 Mar 15. doi:10.1155/2018/7631659
  3. Al-Rubeaan, K, Derwish, M, Ouizi, S, Youssef, A, Subhani,S, Ibrahim, H, et al . (2015). Diabetic Foot Complications and Their Risk Factors from a Large Retrospective Cohort Study. Plos Medicine. 1 (1), p1-2
  4. https://www.diabetesonthenet.com/journals/issue/578
  5. Alexiadou K, Doupis J. Management of diabetic foot ulcers. Diabetes Ther. 2012;3(1):4. doi:10.1007/s13300-012-0004-9

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