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Diabetes and foot problems

Diabetes is a metabolic disease in which the patient suffers from high blood glucose levels. A diabetes patient usually experiences a host of health complications, however, the most common one is ‘foot problems’. A patient with diabetes is always advised to maintain good foot hygiene and follow a good foot care regime. Some serious complications like diabetic neuropathy and peripheral vascular disease are predominantly seen in people with diabetes. Read on to understand the foot problems and complications that arise due to diabetes.

Diabetic neuropathy
Diabetes can have a detrimental effect on nerves. It damages the nerves in the legs, and may cause ‘sensory diabetic neuropathy’, in which the feet completely lose sensation i.e. they cannot feel heat, cold or pain. The patient cannot sense any foot problems like cuts or wounds, and very obviously, does not tend to them immediately. This can worsen the condition and also cause infection. As the nerves get damaged, the feet muscles also do not function properly, leading to a misaligned foot placement. Foot ulcers are also common in people who suffer from damaged nerves and peripheral vascular disease.

Peripheral vascular disease
Uncontrolled diabetes also affects blood flow in the body. Due to poor blood flow, sores and cuts on feet take longer time to heal. This is because the blood vessels in the arms and feet are the farthest from your heart. This condition is known as peripheral vascular disease. If the cuts or wounds do not heal and at the same time, get infected, there is a risk of developing foot problems like ulcers or gangrene.

Some common foot problems in diabetes
Athlete’s foot
Athlete’s foot is a fungal infection that causes scaling, itching and flaking on the skin of the feet, especially on the soles and webs of the toes. Cracks or blisters can also develop on the affected area. Athlete’s foot can be treated with medication or creams.

Nail fungus
Foot problems like toe nail fungus infections are very unsightly. In this case the nails that get infected with fungus appear opaque, yellowish in colour and can break easily. In some cases the fungus can build up and the nail can thicken and eventually crumble.

Calluses are caused due to uneven distribution of weight on the feet, or due to an ill fitting shoe or skin abnormality. Some amount of callus formation is common. However, those suffering from diabetes need to take special care. Use good quality shoes that fit well, file your callouses with pumice stone and gently remove the dead skin and tissue build up. Never cut or try to peel the calluses. This will worsen your foot problems and cause bleeding and injuries that may prove to be detrimental. The skin of your feet should be pampered with good moisturisers. Your physician may also prescribe medicine to keep the feet soft, callus free and healthy.

Hard skin that builds up at a bony area on the toe or between toes is known as a corn. Corns may occur due to ill-fitting shoes that cause friction with the skin. It is extremely risky for diabetes patients to try to cut or remove the corns with sharp objects. It is also not advisable to use over the counter remedies that claim to dissolve these corns. Skin becomes very soft and supple after a bath, and it is best to use a pumice stone and scrape off the build up of tissue.

Blisters are formed when skin on the feet suffers from excessive friction and forms a liquid filled pocket between the layers of skin. Blisters are painful and may even be itchy, however, they heal naturally. Optimum hygiene should be maintained by diabetes patients in order to avoid infection in these blisters.

When the big toe of your foot bends towards the smaller toe, it causes a bump on the outside edge of the big toe. This bump is identified as a bunion. This phenomenon is more common in women and sometimes runs in families. Apart from abnormal bone structure at birth, wearing high-heeled and narrow toed footwear can also cause bunions. Diabetes patients should make sure that they wear the most comfortable footwear.

Dry skin
Dry skin on your legs may crack and peel and get infected easily. In diabetes patients, the process of healing is very slow. Hence, a simple problem of dry skin can aggravate. Bathing for a long time, or soaking your feet for too long, using harsh soaps, etc. can cause dry skin. Everyone, especially diabetes patients must keep their feet clean and moisturised.

Foot ulcers
Foot ulcer is a sore that can get infected and develop into a serious condition. Diabetes patients are particularly prone to foot ulcers. 15% of all the diabetes patients develop foot ulcer in their life at some point in time. A foot ulcer can be caused due to a minor scrape, cut or even from a shoe bite. Diabetes patients should take good care of their feet and make sure that any cuts, shoe bites or wounds are immediately taken care of. Timely treatment is most important to keep the foot ulcer from aggravating and causing a serious condition.

Hammer toes
Hammer toe is a condition in which a toe, or in rare cases all the toes bend at the middle joint to form an awkward claw like position. It happens because of weak toe muscles that shorten the tendon causing the toe to curl like a claw. The condition can be present at birth or may develop at a later stage. Wearing shoes that are small or have very tight and pointed toes can exert pressure on the toes and cause hammer toes. Diabetes patients should be all the more careful because it can cause problems while walking and further lead to problems such as blisters, calluses and sores. Wearing correct type of footwear, splinting, and toe surgery are some of the treatments options for this condition.

Ingrown toenails
When the edges of your toe nails grow into the skin, the condition is known as ingrown toe nails. The nail edges cut into the skin causing injury, swelling, and pain. The injured skin can also catch infection, and the condition can become serious. Ingrown toe nails usually occur due to wrong foot wear that puts pressure on your toes, and it can aggravate due to running, aerobics and similar activities that cause trauma to the feet. Also, neglecting foot hygiene can cause this problem. Diabetes patients should always keep their feet clean and nails trimmed.

Planter warts
Planter warts is a foot problem identified by a thick callus like growth on the planter surface of your feet, especially on the sole, ball of the foot or on the heel. They are caused due to a virus known as human papilloma virus (HPV). The condition gets aggravated as the skin undergoes friction or pressure. These warts can also develop small pinholes or tiny black spots in the centre. They can look unsightly and disfigured. However, they are usually (but not always) painless and harmless. In case of diabetes patients, in this condition, it is best to consult a doctor.

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