Diabetes mellitus or high blood glucose levels can damage the nerves, kidneys, eyes, blood vessels and also decreases the body’s ability to fight infection. Diabetes can cause impairment of the immune system and damage to the organs if not kept under control. Diabetic people can develop foot problems that can become serious. They may not able to feel his/her feet properly due to the damage to the nervous system. Sweat secretion and oil production which lubricates the foot skin becomes impaired and all these factors can lead to abnormal pressure on the foot skin, bones and joints while walking and may cause the breakdown of the foot skin. Diabetic person may also develop sores because of all such factors. Damaged blood vessels and immune system makes it difficult to heal the wounds in the foot which can lead to bacterial infection of the skin, connective tissues, muscles and bones. These can develop into gangrene. Antibiotics also, don’t reach to the site of infection due to poor blood flow and then only treatment left for this is amputation of the foot or leg.
Diabetic patient should be aware of how to take a proper care of the foot to prevent it from any infection or disease. It is very important to keep a good control of the blood sugar level to prevent diabetic complications. They should learn how to examine their own feet and recognize the early signs and symptoms of diabetic foot problems.
Some signs and symptoms of the foot sores or ulcers may include:
· Drainage from the foot that may stain the socks or leak out in shoe.
· Foul smell or odors from one or both feet
· Dark scabby skin or black tissue called eschar surrounding the ulcer (due to absence of blood flow to the foot)
In some cases, person would not even see any signs or symptoms of ulcers until it become infected. Doctor should be informed at the earliest if there is any skin discoloration such as tissue that has turned black or if there is any pain around the callused or irritated appearing area of the skin.
Some common causes of diabetic foot pain and sores may include:
· Poor blood circulation – poor blood circulation is a type of vascular disease and it can make it difficult for wound to heal as in this blood doesn’t flow to the feet efficiently.
· Hyperglycemia (high blood sugar) – diabetic person has less tendency to fighting off the infections from sores. It can slow down the healing process.
· Nerve damage – nerve damage can lead to loss of feeling in the feet. It reduces the sensitivity to foot pain and results in ulcers caused painless wound.
· Wounded or infected feet – any wound or injury can lead to bacterial infection. Diabetic people has common problem of dry skin that makes feet more prone to cracking. Corns and bleeding wounds also may occur.
It is recommended to the diabetic person to stay off their feet to prevent pain and ulcers. This is called off-loading which is helpful for all types of diabetic foot ulcers. Walking can cause pressure on foot that can make an infection worse. People with diabetes would be recommended wearing diabetic shoes, casts, foot braces, compression wraps or shoe inserts to prevent corns and calluses.
Treatment for foot ulcer infection may depend on its complexity and serious. If the doctor suspects any serious infection, patient may require undergoing X-rays test to see any signs of bone infection or to determine which antibiotic will help. Foot ulcer infection can be prevented with foot baths, enzyme treatments, disinfecting the skin around an ulcer, keeping the ulcer dry. Doctor may prescribe some antibiotics or anti-clotting medicines to treat the infection. A surgery may also be performed to help alleviate pressure around the ulcer by removing the foot deformities or by shaving down the bone. Surgery can also help in preventing the ulcer from becoming worse or from amputation. Foot ulcers can reoccur even after they’ve been treated. Scar tissue can get infected if that part is aggravated again. Patient is advised to wear diabetic shoes to prevent these ulcers from returning.