Suffer from diabetes? Learn about the 10 conditions of diabetic neuropathy and peripheral vascular disease of the legs and feet and how to prevent severe complications from reoccurring.
Believe it or not, around 1.7 million Australians have diabetes.
Diabetics are prone to having problems with their legs and feet due to the following two conditions caused by diabetes:
– Neuropathy (loss of normal nerve function) and
– Peripheral vascular disease (loss of normal circulation).
Living with diabetes means that it is important to take care of your feet because neuropathy and peripheral vascular disease can cause serious lower limb problems if left untreated.
The risk of amputation from severe complications is higher than you think.
Checking your feet daily for changes in skin condition or possible infections can prevent serious complications. This should be done in addition to regular assessments carried out by a podiatrist. If you haven’t had an assessment, it is important to have one booked.
During the initial assessment, a podiatrist will document the level of risk in order to determine the frequency of each visit. Recommended visits of a high-risk patient are usually every 3-6 months whereas low-risk patients are at least once a year.
Seek medical treatment as soon as possible if you notice the following signs:
– Wound not healing.
– Unusual swelling.
– Ingrown nail.
– Bruising or cuts.
The following are 10 conditions of the legs and feet that are not specific to diabetics; however, they occur more commonly to diabetics due to nerve and vascular damage.
1. Athlete’s Foot (Tinea Pedis)
Athlete’s foot is a common fungal infection that affects the skin on the feet and causes itching, redness and cracking. For most people, it often appears on the webbed skin between the toes.
Like all fungal infections, they thrive in a warm and moist environment so make sure your feet are completely dry after showering and wear clean socks at all times.
Footwear can promote the growth of bacteria so it is recommended that you clean, dry and change shoes regularly to prevent the opportunity for bacteria to manifest.
Common symptoms of Athlete’s foot are:
– Intense itching of the foot.
– Redness and scaling on the soles.
– Flaky skin.
– Burning or stinging sensation.
Athlete’s foot can lead to foot or leg infections (cellulitis) if not treated properly. Cellulitis is covered in number 3.
A bunion develops when the bone at the bottom of the big toe moves out of place causing the big toe to point inward (toward the other toes). Bunions can form on one or both feet.
Bunions can be either hereditary or it can be caused by wearing inappropriate shoes over time. For diabetics, the nerve damage can cause muscle weakness and loss of tone in the feet.
Bunions can be painful so it is important to avoid shoes with a narrow toe.
It is recommended that you book an appointment with a podiatrist to discuss the option of surgery or footwear.
Cellulitis is a bacterial infection of the skin and tissue. This infection occurs from a wound or sore and the result can be life-threatening if left untreated.
Cellulitis can appear anywhere on the body; however, the legs are a common area.
Common symptoms of cellulitis are:
– Warmth of the affected area.
If you experience any of the above symptoms, seek medical assistance immediately.
4. Charcot Arthropathy (Charcot’s Foot)
The bones in the foot become weakened causing fractures and dislocations. The patient will feel little pain due to neuropathy. The result often leads to severe deformities of the foot.
Common Charcot’s foot symptoms are:
– Warmth to the touch (the affected foot feels warmer than the other).
– Redness in the foot.
– Swelling in the area.
Such a condition may require surgery or it can be simple as finding the right footwear. In either case, see a podiatrist for their recommendation.
5. Corn And Calluses
A callus is a build-up of hard skin, usually on the bottom of the foot caused by the uneven distribution of weight.
Corn is a build-up of hard skin near a bony area of a toe or between toes.
Corn and calluses are not normally harmful, but for a diabetic, the result can lead to an infection if left untreated. Do not attempt to remove them yourself. Always book an appointment with a podiatrist to carry out the treatment.
Shoes are often the factor behind the condition. If the shoe is too tight, it creates pressure on the skin. If the shoe is too loose, they can cause friction. When possible, wear socks to prevent corn or callus from occurring.
6. Dry Skin
Dry skin is common among diabetics due to neuropathy that prevents sweating. Sweat is important to control the moisture balance of the skin.
Dry skin on the legs and feet can cause cracks which allow bacteria (cellulitis) to enter.
Maintain a daily routine of moisturizing with non-fragrant soaps and moisturisers to help keep your skin moist and soft in order to prevent bacteria from entering the skin.
7. Fungal Infection Of Nails
Fungal nail infection is caused by fungus spreading under the nail. In some cases, it may separate from the bed of the nail.
The nail becomes discoloured (yellowish-brown or opaque) and quite often produces an odour.
Certain shoes can promote fungal growth because of the dark, moist and warm environment of which they thrive in.
If left untreated, the likelihood is high for developing other infections such as cellulitis, ulcers and even gangrene (see below).
Gangrene is a condition that occurs when body tissue dies due to loss of blood supply.
There are two types of gangrene: dry and wet.
Dry gangrene is common in people with diabetes. It develops when blood flow to the affected area (feet in this case) is impaired as a result of poor circulation. The tissue dries up and may be brown, purplish-blue or black in colour.
Wet gangrene is caused by an injury so severe that it cuts off blood supply to the affected area, causing tissue decay and increased risk of infection. The term ‘wet’ comes from tissue swelling and blisters due to pus.
Once gangrene is present, amputation is often the remedy.
A hammertoe is a condition where a toe is bent due to weakened muscle. The weakened muscle makes the tendons shorter causing the toe to curl under the feet.
Hammertoe can be caused by arthritis, wearing inappropriate shoes or hereditary.
For diabetics, the result often leads to an infection or an ulcer due to irritation caused by excessive rubbing.
Hammertoes may require surgery or it can be simple as finding the right footwear. In either case, see a podiatrist for their recommendation.
A foot ulcer is a break in the skin or a deep sore which can become infected.
Poor fitted or poor quality shoes can cause rubbing of the skin or cuts which heal slowly. This is the reason why booking a footwear assessment with your podiatrist is important.
Early signs of an infection are unusual swelling, redness, irritation or odour.
If you have an elderly family member, it is recommended that you check for stains on socks or around the shoe itself for any leaks from the wound.
Sometimes, symptoms of an ulcer are not obvious so it’s best to see a podiatrist as soon as you notice a slight discolouration on the skin or pain around the areas that appear callused or irritated.
By monitoring your feet on a daily basis for changes in skin condition and booking regular assessments with your podiatrist will help prevent serious complications and undue stress on yourself and family members.
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