How Does Diabetes Affect the Feet?
Foot concerns such as calluses, ingrown toenails, and athlete’s foot are all common conditions that occur in a person regardless of whether or not he has diabetes. The difference is, however, that when these fairly common and non–life threatening concerns occur in a diabetic, the results can range from severe infection to gangrene to amputation.
According to the National Institute of Diabetes and Digestive and Kidney Diseases, foot problems will most often occur when a limb has suffered some type of neuropathy or nerve damage. When nerve damage occurs, you lose feeling in the extremity affected and may not feel pain, resulting in a painless ingrown toenail or cracked heel that, when left untreated, can escalate quickly into a much more serious problem.
Foot problems can also occur because of blood vessel damage. When blood flow is restricted to the extremities, narrow, hard blood vessels result. This can cause your feet to become cold, sore, and stiff. This can also force your body to take longer to heal from infections.
A number of websites offer extensive lists of foot–related problems that diabetics face and proper foot care tips that can help prevent further concerns. Below is a summary of a few of the most common foot conditions adapted from the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) website:
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Corns and Calluses. Corns and Calluses are thick layers of skin caused by too much friction or rubbing in one area. They may become infected over time. To manage at home, use a pumice stone after baths to scrub away dead skin. Never cut corns or calluses yourself as improper cuts can lead to ulcers and open sores. Have your doctor trim them if needed. |
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Blisters. Blisters are similar to corns or calluses in that they occur when one area is rubbed too much or receives too much pressure. However, blisters are pockets of skin filled with water. They, too, can become infected. Avoid wearing shoes without socks or shoes that are too big to prevent blisters, and do not pop existing blisters. Instead, cover with protective bandaging and allow healing time. |
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Ingrown toenails. Ingrown toenails are a result of the toenail growing too close to the edge of the skin. The skin can become red and infected. Ingrown toenails result when the edges of the toenail are cut or your shoes are too tight. To avoid this, cut toenails straight across and avoid overcrowding the toes. |
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Bunions. Bunions form when the big toe slants toward the small toes, forming a bump at the base of the big toe. The spot can become red, irritated, and infected. The most common cause of a bunion is pointed shoes, although they can be inherited, too. |
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Plantar warts. Plantar warts are warts that form on the bottom of the feet. Rather than form a raised bump like a regular wart, these form more like calluses, although they should be discernable by the black seeds visible within them. Caused by a virus, plantar warts can form in groups or alone. They tend to go away without treatment; although if they become too painful, ask your doctor for assistance. |
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Hammertoes. Hammertoes form when a muscle in the foot gets weak, causing the tendons to shorten and a toe to retract. This results in a bump at the joint of the toe. This toe can become sore and can cause problems walking long distances or finding comfortable shoes. |
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Dry, cracked skin. Dry, cracked skin can result when nerve damage prevents the foot from receiving the message that that it is no longer moist and soft. Severely cracked skin can admit germs into the body, and high blood sugar levels can feed the germs, causing a nasty infection. |
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Athlete’s foot. Athlete’s foot is a fungus that is itchy and causes redness and cracking of the skin. The cracked skin can admit germs and high blood sugar levels fuel the germs. If athlete’s foot spreads to the toenails, it can cause thick, yellow nails that are hard to cut. |
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Graphics courtesy of the National Institute of Diabetes and Digestive and Kidney Diseases |
Smoking and Foot Care
Whether or not you smoke is an important factor in the health of your feet when you have diabetes. Smoking causes the restriction of small blood vessels, creating poor circulation or blood flow. According to the NIDDK’s Feet Can Last a Lifetime guide for health care providers, approximately six in every 1,000 diabetics have an amputation; what’s more is the American Diabetes Association states that a great number of those who require amputations are smokers. And your feet are not the only part of your body with the potential to suffer from the effects of smoking; you are also putting your heart at greater risk.