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Diabetes

Overview

What Is Diabetes and How Does It Affect Your Feet?

Diabetes is a serious condition characterized by high blood sugar levels that can lead to blood flow and nerve issues.  The tiny nerves and blood vessels in our feet and toes are especially vulnerable to complications from diabetes.  

The two main complications affecting the feet (which can lead to a myriad of other issues), are: 

  1. Diabetic Neuropathy:  Diabetes causes nerve damage, which can lead to loss of sensation in the legs, feet and toes. This means if you injure your foot, you wouldn’t notice it right away.  The nerve damage can also affect the way we use the muscles in our feet, which can lead to misalignment, injury and various other foot conditions.
  2. Peripheral Vascular Disease:  The accumulation of sugars in the bloodstream causes poor blood circulation.  Poor circulation makes it difficult for wounds in our feet to heal, and can lead to infection. 

As a result, common foot problems can lead to serious complications. In severe cases, infections in the feet may lead to gangrene and possibly amputation of the infected areas.  

Constant monitoring and specialized foot care from a foot specialist is essential for diabetes patients.  A chiropodist can help you keep your feet healthy:  they will check for adequate circulation, any signs of neuropathy, risk for foot ulcers, and manage any nail and skin concerns.  

Symptoms

Signs and Symptoms

In people with diabetes, common foot problems can cause serious complications.  Even seemingly small and normal issues require the attention of a foot specialist.  

Contact your doctor immediately if you have diabetes and your feet display any of the following signs and symptoms: 

  • Skin change, i.e., a new callus, blister, or ingrown toenail
  • Colour change
  • Temperature change
  • Swelling
  • Tingling or burning
  • An open or infected sore

Diabetes-Related Foot Complications

Diabetes can cause the following complications and symptoms in the feet:

  • Loss of sensation (Diabetic Neuropathy)
    Diabetes can cause nerve damage that reduces sensation in your feet. If you can’t feel pressure, pain, or changes in temperature, you may not notice if your feet or toenails become injured.
  • Foot Infection
    Benign foot injuries often become infected. Diabetes can cause decreased blood flow in your feet, which prolongs healing time and impairs your body’s ability to effectively fight off infection in the area. Combined with a reduced ability to feel pain and detect an injury, poor circulation can lead a cut or scratch to become further inflamed or infected, without you even noticing.
  • Foot Ulcers
    An ulcer is an open sore that is slow to heal and may reoccur. Because wounds heal slower (and progress faster) with diabetes, a common foot condition like a blister or cut can quickly turn into an ulcer. Ulcers are particularly common in people with diabetes due to impaired blood flow and a compromised immune system: it is estimated that up to a quarter of people with diabetes will develop a foot ulcer.
  • Musculoskeletal Dysfunction
    Nerve damage can also affect the ability of your foot muscles to work properly, which can disturb normal gait (the way you move when you walk). If there is too much concentrated pressure in one area of the foot, you may develop blisters, calluses, or corns.  In rare cases, bones and toes in the feet may shift and break, which can alter the foot’s shape and lead to deformities (i.e.: Charcot’s foot).
  • Gangrene
    Gangrene occurs when tissue in your body dies due to lack of oxygenated blood. When peripheral vascular disease from diabetes severely reduces blood flow to the feet, it can lead to gangrene. Gangrene is a medical emergency.
  • Amputation
    If an infection cannot be contained and spreads to the bone, the foot or leg may need to be amputated to prevent further infection spread and loss of life.  

Putting your feet in the hands of a healthcare professional will reduce the risk of infection and diabetic complications.

To schedule a diabetes foot exam, use the booking form below or call 416-769-FEET(3338). You do not need a physician’s referral.

Causes

How Does Diabetes Cause Foot Complications?

Diabetes is a disease of the pancreas.  The pancreas is responsible for producing insulin, a hormone that lets our body break down the sugar (glucose) from food and convert it to energy.  In diabetic patients, the pancreas does not work properly.  This causes a chain reaction throughout the body, as our organs rely on the energy from glucose in order to function.  The chain reaction leads to poor circulation (Peripheral Vascular Disease) and nerve damage (diabetic neuropathy).  

Diabetic neuropathy can cause loss sensation to the limbs and feet.  This is problematic because pain is our body’s way of telling us something is wrong so that we can fix it: if we lose feeling in our feet from diabetic neuropathy, it means we may not notice if there’s something wrong that needs attention.  

On top of that, diabetic patients don’t have enough blood flow to their feet due to Peripheral Vascular Disease.  Good blood flow is required to stimulate our body’s healing process and immune response – without it, the feet’s ability to heal from wounds is compromised. That means otherwise benign issues that typically go away on their own, like a callus or sore, cannot heal properly and may become infected.  

The compromised immune system of diabetes patients has difficulty fighting off these infections.  If the infection grows, it can cause gangrene (tissue death) and foot ulcers.  If these get worse, it can lead to irreparable damage in the foot, which can lead to amputation.  

In rare cases, nerve damage from diabetes can also change the feet (i.e.: Charcot’s foot). This occurs when the bones and toes in the feet shift and break as a result of compensating for nerve damage.  The shifting and breaking of the bones affects the shape of the feet.

Treatment

How Do I Treat Diabetic Foot Complications?

Foot problems for diabetes patients can be a “double whammy”:  1) Diabetes makes you more vulnerable to developing complications from common, seemingly harmless foot issues (like a cut or scrape); and 2) You may not even notice these issues when they arise due to diabetes’ effect on your ability to feel sensation in your feet. 

Therefore, in order to manage and prevent complications in your feet, it’s important to be proactive and seek treatment from a foot specialist on a regular basis, ideally before issues arise.   

Treatment for diabetes-related pain and complications affecting the feet may include:

  • Diabetic foot assessment by a foot specialist:  A licensed chiropodist will check for adequate circulation, any signs of neuropathy, risk for foot ulcers, and manage any nail and skin concerns. 
  • Nail care and callus care:  A medical pedicure at a foot clinic by a medical health professional is highly recommended for diabetic patients. Routine medical pedicures will ensure your feet are on the right path to proper foot health by managing existing problems as well as detecting issues early on and treating them in their early stages.  It also reduces the risk of accidental cuts, nicks and irritation that can occur at a nail salon, or when you do it yourself – with diabetes, you can’t afford those risks. 
  • Advice on proper footwear and custom foot insolesThis will reduce your risk of developing corns, calluses and other foot issues that may cause complications in diabetes patients.  A foot specialist can help you find the solutions that work best and are perfectly tailored for you and your feet’s needs.  
  • Measuring for and dispensing medical grade compression stockings:  Our foot clinic has a variety of options that are both therapeutic and stylish.  
  • Orthopedic footwear (orthotics):  These are constructed specially for your feet and can accommodate any deformities resulting from diabetes.  They can also help correct the effects of diabetic neuropathy on the muscle function in your feet by adjusting your gait and encouraging biomechanically friendly movement.  
  • Wound care, including wound debridement and application of proper dressings to facilitate healing and manage or prevent infection:  This can be tended to with care by a chiropodist
  • Diabetic foot education:  A foot specialist can provide you with information about how to manage and prevent the effects of diabetes on your feet.  You can also check out this article on diabetic footcare. 
  • Prescribe medication if indicated

Putting your feet in the hands of a healthcare professional will reduce the risk of infection and diabetic complications.

To schedule a diabetes foot exam, use the booking form below or call 416-769-FEET(3338). You do not need a physician’s referral.

Risk Factors

What Can Cause Diabetic Foot Complications?

Certain risk factors may increase your chances of diabetic foot complications:

  • Poor blood glucose control
  • Poor hygiene
  • Receiving nail care from nail salons that do not use sterilized instruments
  • Foot injury
  • Wearing ill-fitting shoes, i.e.: shoes that are too tight
  • Lack of awareness or failure or seek diabetic foot education from a licensed chiropodist
  • Other foot and joint related disorders (i.e.: arthritis)
Prevention

How Do I Prevent Complications?

Promptly identifying and treating skin and toenail problems is critical for preventing complications.  With routine and diligent footcare and foot monitoring, you can reduce your risk of serious complications or prevent them entirely. 

Prevention measures include:

  • Annual or semi-annual foot assessments by a foot care specialist that includes a thorough examination that checks for and treats:
  • Wash (not soak) your feet daily with warm, soapy water
  • Dry your feet thoroughly after bathing or taking a shower – do not forget in between the toes
  • Check your feet daily for injuries
  • Moisturize your feet if they become dry to prevent cracking
  • Trim your toenails once per month – if you cannot safely trim your nails, schedule a diabetes nail care appointment with one of our practitioners
  • Wear compression socks to help improve circulation in the feet and lower legs
  • Wear closed-toe orthopaedic shoes with a roomy toe-box, flexible fabric upper, and soft breathable lining to minimize rubbing and pressure against the skin of your feet.  This will reduce your risk for developing blisters, calluses, and corns
  • Avoid wearing sandals and walking barefoot:  Diabetes turns a small cut into a big deal.
  • Wear moisture-wicking socks to control sweat levels that might exacerbate athlete’s foot or blister-causing friction
  • Wear white socks:  This makes it easier to notice blood or other signs of broken skin

Diabetic care products, including orthopedic shoes, compression stockings, medical creams, and foot care tools, are available in our Toronto foot clinic.

Prevention is paramount to managing the effects of diabetes on your feet.  Putting your feet in the hands of a healthcare professional is one of the best, proactive ways to prevent diabetic complications. To schedule a diabetic foot assessment with our licensed Chiropodists (foot specialists), use the booking form below or call 416-769-FEET(3338).

Our Toronto foot clinic is open Monday-Friday 10am-6pm, Saturdays 9am-4pm. You do not need a referral to become a patient at our Foot clinic.

Articles about Diabetes by Feet First Clinic

Book an appointment for diabetes

You do not need a referral to become a patient at our foot clinic. Schedule an appointment by using the Appointment Request form below or contact the clinic at 416-769-FEET(3338).