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Diabetic Complications and Amputation Prevention

By October 4, 2012No Comments

Diabetics are at increased risk for foot problems. However, consistent visits with your Podiatric Foot and Ankle surgeon can decrease the chance for infection or problems to develop. Infection is often preceded by neuropathy or decreased nerve function. Neuropathy causes loss of feeling in your feet, taking away your ability to feel pain and discomfort, so you may not detect an injury or irritation. Furthermore, in diabetes, small foot problems can turn into serious complications.

Common Diabetic Complications in the Foot

  1. Infections and ulcers (sores) that don”t heal. Together with decreased nerve function, poor circulation in the feet can prolong the healing time of ulcers. The longer it takes a wound to heal the greater the chance for infection to develop.  This is a common and serious complication of diabetes and can lead to a loss of your foot or your leg.
  2. Corns and calluses. When neuropathy is present, you can”t tell if your shoes are causing pressure and producing corns or calluses. Corns and calluses must be properly treated or they can develop into ulcers.
  3. Dry, cracked skin. Poor circulation can make your skin dry which can lead to cracking and possible infection.
  4. Nail disorders. Ingrown toenails and fungal infections can go unnoticed because of loss of feeling. If not treated and left to progress ulcers can develop.
  5. Hammertoes, bunions and bony prominences. Any bony prominence that may lead to skin irritation, especially in shoe gear, can progress to skin breakdown.
  6. Charcot foot. This is a complex foot deformity that develops as a result of loss of sensation and leads to destruction of the soft tissue of the foot. Typically, patients do not notice the presence of a sore because of neuropathy. The sore goes unnoticed as the patient continues to walk on the bony prominence worsening the sore. Often bony remodeling and amputation is necessary.

Treatment Objectives
The ultimate goal of your Podiatric Physician is to prevent amputation and loss of function. There are many new surgical techniques available to save feet and legs, including joint reconstruction and wound healing technologies. Getting regular foot checkups and seeking immediate help when you notice something can keep small problems from worsening. Your foot and ankle surgeon works together with other health care providers to prevent and treat complications from diabetes.

What You Can Do 
Follow these guidelines and contact your foot and ankle surgeon if you notice any problems:

  1. Inspect your feet daily. Look for any open sores, injuries, redness or swelling.
  2. Changes in circulation. Pay attention to the color of your toes. Purplish discoloration in the toes may be a sign of decreased blood flow.  Also, pain in the leg that occurs when walking or at rest can be a vascular blockage. Seek care immediately.
  3. Nail trimming. If you have thick nails, hard nails, or reduced feeling in your feet, your toenails should be trimmed professionally.
  4. No bathroom surgery. Never trim calluses or corns yourself and don”t use over-the-counter medicated pads.
  5. Don”t go barefoot. Wear shoes, indoors and outdoors. Keep floors free of sharp objects. Make sure there are no needles, insulin syringes, or other sharp objects on the floor.
  6. Have your sense of feeling tested. Your foot and ankle surgeon will perform various tests to see if you”ve lost any feeling.