The Diabetic Foot
Diabetes causes vascular and nervous system changes throughout the entire body, and one of those types of changes relates to the feet. The most common changes experienced by many diabetics is decreased circulation and decreased ability to feel where the foot is in space, heat sensations, cold sensations or pain. The loss of sensation in the foot is called neuropathy. Thus the term “diabetic foot” usually refers to the neuropathy found in a diabetic. Diabetics are also prone to develop infections due to decreased immunity. Their ability to recover from infections is also depressed. This means that a diabetic with an infection can potentially develop a raging infection that turns into blood poisoning and needs the amputation of the foot – or toe. Thus, another definition for “diabetic foot” is the foot of a diabetic that has impaired circulation and is susceptible to infection, and is subsequently at risk for amputation. Cause Neuropathy occurs in about 1 out of every 4 diabetics and is due to the high levels of blood sugar in the bloodstream. The sugar deposits on the nerves, deadening them to feelings. Because the feelings are deadened, infections and foot deformities are more likely to result and progress because the diabetic does not feel them occurring. Poor circulation results from narrowing of arteries and disappearance of the small arterioles that bring circulation to the foot. Poor circulation can result in a foot that doesn’t sweat, or to swelling, which causes friction on the toes, leading to corns, ulcers, infections, calluses and hammer toes. The root cause of the impaired circulation is diabetes itself. Treatment & Prevention The first line of defense against developing a diabetic foot and all its associated ailments is the elimination of diabetes or at least the excessively high blood sugar levels which cause further progression of the neuropathy, impaired circulation and disease itself. The second line of defense against developing a diabetic foot is proper footwear along with diabetic insoles and the normalization of the biomechanics of the feet. Diabetic shoes must be: • wide enough • tall enough in the toe area • correct any arch anomalies • reduce pressure on any areas of the foot that is bothered by friction • correct any present deformities such as corns, bunions, calluses, and hammer toes • provide firm support of the heel for foot stability The third line of defense involves proper hygiene of the foot with daily checking for infection, cuts, scrapes, sores, swelling or any other issues as well as daily washing and drying of the feet. Fresh socks should be worn daily; seamless socks and padded socks are best. The skin should be kept soft with lotion or essential oils. Barefoot walking is not recommended. The fourth line of defense involves the restoration of the microcirculation of the foot. The only known way to do this is with hyperbaric oxygen treatment, which is usually accepted by insurance companies for diabetics, especially if they are facing amputation. Breathing levels of 100% oxygen under pressure forces the new formation of these small blood vessels.