The Importance of Foot Care in Diabetics

With the 87th Academy Awards concluded, many people will certainly be seeing movies like American Sniper, Imitation Games, and The Theory of Everything. This is a unique year in that many of the big stars of the last decade or two (Tom Hanks, Julia Roberts, etc.) have stepped to the side to allow a new generation of young stars (and even a couple no-names) to shine.

We haven’t seen much of Tom Hanks this year. In fact, one of the last memories I have of him was his appearance on “Late Show with David Letterman” in October of last year when he announced he had officially been diagnosed with diabetes. 

Diabetes has become an epidemic in this country and beyond. Worldwide prevalence is expected to double from the year 2000 to 2030. Currently 366 million people have diabetes, and it is projected that far more people have it and don’t know it. It is important that diabetics realize the different manifestations of the disease as it can cause very serious problems in the foot and ankle. Studies show that 15% of diabetics will experience at least one foot ulceration.

Diabetes is caused by an elevation of blood sugar. This can be due to the lack of generation of insulin (a protein in the body that assists in taking sugar out of the bloodstream) or an inability of the body to recognize insulin. These two different mechanisms summarize the difference between Type 1 and Type II diabetes, respectively.

When sugars cannot escape the bloodstream, they accumulate to levels that can be toxic to organs. The most commonly affected organs are the eyes, kidneys, and blood vessels. The increase in blood sugar can also damage nerves resulting in tingling, burning, and eventually all loss of feeling. The inability to feel the bottoms of your feet mean you cannot feel pain. If you cannot feel pain, then you could easily do something to damage the skin on the bottoms of your feet without ever even knowing it. This is usually how a diabetic foot ulcer begins.

Once an ulcer starts, it is very difficult to get them to heal in diabetic patients. This is due to the effect of high blood sugar on your blood vessels I briefly mentioned earlier. Since the excessive amounts of blood sugar damage the vessel walls and lead to poor circulation, the proteins your body creates to initiate healing cannot reach the damaged, ulcerated area of the foot. Think of your bloodstream as a highway, the healing proteins as cars, and the ulcer as a car wreck. The paramedics (cars) cannot reach the accident (ulcer) without an unobstructed highway (blood vessels).

It is crucial that diabetic patients include a podiatrist as a part of their health team. Here at Cast A Foot Podiatry in Hempstead, I specialize in diabetic foot care and can help prevent and/or treat foot ulcers. If you are a diabetic or have a family member that is, call our office and schedule a diabetic foot care evaluation today.  The next few blogs will focus on these prevention and management strategies.

 

Dr. Nicole Castillo

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