Cases of diabetes are increasing across the U.S. Diabetes can cause several other subsequent health problems. In particular, diabetics have a higher risk of developing lower extremity issues.
Diabetes leads to poor microcirculation, disease of the small blood vessels, and neuropathy. These patients may lose feeling in the feet, which, coupled with poor circulation, can lead to very serious infections.
Our foot and ankle specialists, Dr. Aron Green, Dr. Eric Beights, and Dr. George Fahoury, are skilled in diabetic foot care and can help patients treat and prevent foot problems associated with diabetes.
How Do Infections Occur in Diabetic Patients?
Diabetic patients may experience chronic nerve damage called neuropathy, which often results in a loss of feeling in the feet. These patients often do not feel trauma or irritation of the foot, so many wounds are not discovered or treated right away.
Neuropathy can also cause the skin to become very dry and cracked, allowing infection-causing bacteria to enter. Diabetic patients also have poor blood circulation, which can lead to the development of ulcers on the feet.
In diabetic patients, small wounds like ulcers and cracked skin can develop into very serious infections if left untreated. These infections can be very difficult to treat due poor blood supply–the blood cannot adequately deliver antibiotics to the wound site. Thus, many diabetic wounds are difficult to heal.
Complications from Diabetic Wounds
Because it is difficult to treat infections in diabetic patients, it is important to get treatment as soon as possible to avoid potential complications. Even if a wound seems minor or is not painful, it can still lead to a very serious infection.
Serious infections in the feet can lead to hospitalization. There are often several facets to treating a diabetic wound. Your doctor may need to clean out and remove any dead or infected tissue. Antibiotics are also administered to help clear up the infection. A vascular surgery evaluation may also be recommended.
If the infection is unable to be cleared up through antibiotics and cleaning out diseased tissue, amputation is often necessary. This is unfortunately very common for diabetic patients, as poor blood circulation makes it difficult to heal infections in the feet.
Diabetic patients who have had a foot or leg amputation have a very high risk of having the opposite foot or leg amputated within five years. Furthermore, there is a very high five-year mortality rate associated with amputations in diabetic patients.
To avoid serious complications, it is important that diabetic patients take good care of their feet.
Diabetic Foot Care to Avoid Infections
Preventative care is extremely important for diabetic patients. We recommend the following to patients to avoid serious complications.
Inspect Feet Three Times a Day
Patients should inspect their feet daily to look for wounds, as well as redness, warmth, bruising, blisters, and nail problems. Patients should use a mirror to look at the bottom of the feet. Any abnormalities should be treated right away to avoid complications. Patients should also look for swelling, because that is an early sign of Charcot arthropathy, which can cause the foot to become deformed and may lead to disability.
Practice Daily Foot Care
Diabetic patients should clean their feet daily with warm water and mild soap. However, patients should not soak their feet, as it can dry out the skin. After washing, carefully pat the feet dry with a towel, taking care to eliminate all moisture while avoiding vigorous rubbing. Unscented lotion or a thin coat of plain petroleum jelly should be applied after washing to lock in moisture and prevent dry skin. However, avoid putting creams and lotions between the toes, as the extra moisture can lead to an infection.
Toenails should be trimmed straight across. Avoid cutting corners to prevent ingrown toenails. If present, ingrown toenails should be treated right away to reduce the risk of infection. Patients should wear socks at night and during cold weather to keep the feet warm.
While not technically foot care, it is also important that diabetic patients avoid smoking. Smoking damages the blood vessels, decreasing available oxygen, which combined with diabetic nerve damage and poor circulation, can increase your chances of an amputation in the future.
Wear Appropriate Shoes and Orthotics
Patients should choose shoes that are comfortable and well-fitted. Avoid shoes that are too tight or small, as well as shoes with pointed toes and high heels. Custom orthotics and even custom footwear can help to accommodate foot deformities and provide relief from neuropathy and poor vasculature.
Diabetic Foot Care in Central New Jersey and Jersey Shore
Regular foot care is extremely important for diabetic patients. Our foot and ankle specialists at Seaview Orthopaedic can help. Dr. Aron Green, Dr. Eric Beights, and Dr. George Fahoury are available for appointments at our five office locations to help with your foot care needs. If you would like to schedule an appointment, please call (732) 660-6200. We are happy to help!