Category Archives: Diabetic Complications

Prevention of Diabetic Foot Ulcers

Diabetes is a disease that can have a lot of complications. This chronic lifestyle disease can increase the risk of heart diseases, kidney disorders, blindness, circulatory problems, and it can even cause foot ulcers that can end up requiring amputation of the lower limbs.

Foot ulcers are very common among diabetics. It is important that you should know how to prevent this from happening to you as this is the most common cause of non-traumatic amputation of the lower limbs. Any person with diabetes can have foot ulcers. However, there are several factors that significantly increase the risk. By learning about the factors that increase the risk of foot ulcers, you will be able to know how to effectively prevent it.

Poor blood glucose control is one major factor that increases the risk of developing foot ulcers. Other factors that significantly increase the risk of developing foot ulcers in diabetic patients are sensory neuropathy, poor circulation, poor foot healthcare, inappropriate or ill fitting footwear, foot deformity, and history of previous ulceration.

If you are suffering from diabetes and that you have neuropathy and reduced or poor circulation, then you are very likely to get foot ulcers. This is a classic example of the causes of foot ulcer. If you decide to go on a long walk with new shoes and that you have neuropathy and poor circulation, then it is very likely that you will develop foot ulcers. The new pair of shoes and the duration of the walk can cause chaffing in the feet, which you will not feel as you have loss of feeling in the feet or because of sensory neuropathy. The chaffing will then develop in to a blister, which you will not notice for the same reason.

This happens because of the poor blood circulation, so the blister doesn’t heal and therefore turns into an ulcer.

This is one scenario that can possibly cause foot ulcer. Other classic cases would be getting an ingrown toenail which can cause injury to your feet and further +develop to foot ulcers.

Here are ways on how you can prevent foot ulcers. By following these tips, you can be sure that you will be able to decrease the risk of developing foot ulcers and decrease the likelihood of amputation.

The first is to check your blood glucose level regularly. By doing so, you will be able to effectively monitor and regulate your blood glucose levels at acceptable levels.

In addition to that, checking your feet using a mirror is a must especially if you have sensory neuropathy. By doing so, you will be able to know if you developed chaffing in your feet, which can develop in to blisters then in to foot ulcers.

Cleaning the feet with warm water and mild soap can also help prevent foot ulcers. Always remember that after every washing, you need to dry your feet thoroughly especially between the toes.

In case you have decided to cut toenails, never cut down in to corners as this can lead to an ingrown toenail to develop. Instead, try cutting the toenails straight across. If you are in doubt about the way to cut your toenails properly ,it is better you consult a podiatrist.

Appropriate footwear is important for diabetics. Make sure that the shoes you get fit you adequately. Consult your podiatrist in order to make sure that the shoes you get is comfortable and one that has enough space for your feet that it will not cause injuries.

These are some of the ways to prevent foot ulcers when you have diabetes. By following these tips, you can be sure that you will decrease the risk of getting foot ulcers, which will basically reduce the risk of amputation.

Diabetes Foot Problems – Charcot’s Foot

One of the longer term complications of diabetes is nerve damage where feeling in the lower limb is lost. Try to imagine what happens if you can’t feel your feet and you sprain your ankle. As you can’t feel it, imagine what happens as you keep walking on that sprained ankle. This is what can happen in diabetes and is known as Charcot’s foot (or Charcot’s neuroarthropathy).

What Happens If You Have Charcot’s Foot

Essentially what happens in Charcot’s foot is that the ability to feel pain is lost or impaired (due to the diabetic nerve damage). The muscles can then loose their ability to properly support the foot. Then minor trauma (eg sprains or stress fracture) to the foot go undetected and no treatment is given. Continued walking on the foot further increases the damage.

Usually the first sign is that the foot is warm and swollen and no pain will be present. A deformity then will start to develop if no treatment is provided.

Prevention Of Complications With Charcot’s Foot

Prevention of further joint destruction and foot deformity is the main aim in treatment. Total rest is essential and support is needed to stabilise the damaged area. Most cases will be put in a plaster or fibreglass cast called a ‘total contact cast’ to relieve pressure and to prevent further deformity. This can take up to 6-9 months to heal properly. A drug (called a bisphosphonate) have been shown to be useful in many cases.

After the Charcot foot has healed then specialized footwear and foot supports may be needed to prevent it occurring again. If the deformity is severe or it happens again, then surgery may be used to reshape the deformity.

Possible Warning Signs For Charcot’s Foot

If you have diabetes and start to loose sensation in your feet and legs, then the risk for developing Charcot’s is high. Feet need to be checked regularly for any signs of swelling, redness or temperature changes. Very prompt medical attention is needed to halt the progression of the problem.

If you are a health professional, the most recent information on Charcot’s neuroarthropathy is available at Podiatry Arena. If you have Charcot’s and want to ask questions about it or make contact with others who have it, then there are the Charcot’s Foot threads at the Foot Health Forum.

Diabetic Neuropathy

Many people with diabetes develop the complication of diabetic neuropathy. The risk becomes greater the longer you’ve had diabetes and the older you are. The highest rate of neuropathy is amongst people who had this disease for at least twenty five (25) years.

Often the symptoms are slight at first, and may go unnoticed for a long time. Some of the symptoms include:

· Numbness and Tingling sensation on the extremities
· Dyesthesia – loss or decrease of sensation
· Diarrhea
· Urinary Incontinence – loss of bladder control
· Erectile Dysfunction
· Impotence
· Vision Changes
· Dizziness
· Muscle Weakness
· Speech Impairment

There are four types of diabetic neuropathy: peripheral, autonomic, proximal and focal.

Peripheral Diabetic Neuropathy

The feet and legs are the areas of the body most often affected by peripheral neuropathy. The loss of sensation in the feet may increase the possibility for foot injuries to go unnoticed and develop into ulcers or lesions that become infected. It is important to practice good skin and foot care to prevent problems.

Some symptoms of diabetic peripheral neuropathy include burning (especially in the evening, tingling, pain, and numbness. Sever or long-term numbness can become permanent.

Diabetic Autonomic Neuropathy

The digestive system is most often affected by diabetic autonomic neuropathy, causing problems with the stomach.  It also affects blood vessels, the urinary system and sex organs.

Symptoms of diabetic autonomic neuropathy include bloating, constipation, diarrhea, heartburn, nausea and vomiting.

When diabetic autonomic neuropathy affects blood vessels, symptoms include blacking out when standing up quickly, dizziness, an increased heart rate and low blood pressure.

Male sex organs may also be affected, resulting in an inability to have or maintain an erection, and/or reduced ejaculations. Females with diabetic autonomic neuropathy may experience a decrease in vaginal lubrication and decrease in the number of orgasms or lack of orgasm.

Diabetic autonomic neuropathy can also affect the urinary system resulting in incontinence, increased urination at night, and being unable to completely empty the bladder.

Diabetic Proximal Neuropathy

This type of neuropathy causes pain in the thighs, hips or buttocks, and usually just on one side. It can also lead to weakness in the legs.

Diabetic Focal Neuropathy

So-called because it affects specific nerves, diabetic focal neuropathy usually affects the head, torso or leg. It causes muscle weakness or pain and can appear suddenly. Other symptoms include double vision, eye pain, paralysis on one side of the face (Bell’s palsy), or severe pain in the lower back, legs, chest or abdomen.

Treatment for Diabetic Neuropathies

Medications are available to help with diabetic neuropathic pain. These drugs include tricyclic antidepressant, pregabalin, topical lidocaine, duloxetine and gabapentin. Further medications are also used such as carbamazepine, lamotrigine, phenytoin, opiods and oxcarbazepine. New drugs are being developed all the time, such as Lyrica (pregabalin).

Topical Medications are also used, such as lidocaine patches or capsaicin. These are most helpful for diabetic patients with localized pain.

As with all medications, there are usually side effects, especially if not used properly. Be sure to follow directions!

Prevention Is Better

Managing Diabetic Neuropathy can be difficult. The best course of action is prevention. Controlling diabetes and maintaining a normal blood glucose will help prevent such complications.

Exercise, eating the right diabetic foods, and otherwise maintaining a healthy lifestle will help prevent this complication.