How can diabetes affect my feet?

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Ronald Tamler, MD
Endocrinology Diabetes & Metabolism
High blood sugar can damage the nerves that lead to your feet. In this video, Ronald Tamler, MD, clinical director of the Mount Sinai Diabetes Center, explains why you should pay attention to your feet if you have diabetes.
James P. Ioli, DPM
Podiatric Medicine
The prolonged effects of diabetes and elevated blood sugar may eventually damage not only vital organs like the heart and kidneys, but also nerves and blood vessels, including those that serve the feet. The nerve damage caused by diabetes can lead to peripheral neuropathy (impaired nerve function due to systemic damage of the peripheral nerves), which may make your feet less sensitive to irritation and pain. As a result, you may not be aware of the discomfort of ill-fitting shoes, or you may not realize that you have suffered a foot injury, allowing the situation to worsen. Diabetes can also impair your circulation, impeding your natural healing capacity and your ability to fight infection.
Foot problems are common in people who have diabetes and often result from nerve damage and poor circulation in the feet. If the nerves in your feet are damaged, you may not realize when you have a foot injury, which could lead to delayed healing or infection. Examine your feet daily to take care of small problems right away. People with diabetes often experience cracked, dry skin on their feet. Wash and dry your feet daily, and apply a thin coat of moisturizer just to the tops and bottoms of your feet to keep the skin soft and smooth. (Don't put moisturizer between your toes -- extra moisture there can promote the growth of germs.) Calluses are also more common in people with diabetes and if allowed to thicken and crack can develop into open skin sores called ulcers. Using a pumice stone daily on your feet may help to control calluses. Exercising regularly to maintain adequate circulation to the feet can also help to keep them healthy. Consult your doctor for more ways to keep your feet healthy when you have diabetes.
Alec O. Hochstein, DPM
Podiatric Medicine

Diabetes, by itself is not painful, but sometimes things than are not painful can still "hurt" you.

Diabetes in its simplest terms is an endocrine disorder that does not let the patient metabolize glucose (the body’s energy source) in an effective way. This leads to an excessive amount of un-metabolized or poorly metabolized "sugar" in the blood.

Due to this malfunction of the endocrine system many systems in the body become affected. Two of these are the neurovascular system, as well as the immune system.

When a patient is unable to control his or her blood glucose levels, the sequelae of this can manifest itself in the feet in the form of poor circulation, non-healing wounds that may lead to deep infections that may necessitate the need for surgery including the possibility of amputations.

As a Podiatric Surgeon, I am often called on to evaluate and treat these patients, and while Diabetes is a life long illness, we now have effective medicines and lifestyle changes that can afford them a long, and productive life, that can prevent these end results.

High blood glucose from diabetes causes two problems that can hurt your feet:

Nerve damage: One problem is damage to nerves in your legs and feet. With damaged nerves, you might not feel pain, heat, or cold in your legs and feet. A sore or cut on your foot may get worse because you do not know it is there. This lack of feeling is caused by nerve damage, also called diabetic neuropathy. Nerve damage can lead to a sore or an infection. Poor blood flow: The second problem happens when not enough blood flows to your legs and feet. Poor blood flow makes it hard for a sore or an infection to heal. This problem is called peripheral vascular disease (PVD). Smoking when you have diabetes worsens blood flow problems.

These two problems can work together to cause a foot problem.

For example, you get a blister from shoes that do not fit. You do not feel the pain from the blister because you have nerve damage in your foot. Next, the blister gets infected. If your blood glucose is high, the extra glucose feeds the germs, which grow and worsen the infection. Poor blood flow to your legs and feet can slow down healing. Once in a while, a bad infection never heals. The infection might cause gangrene. If a person has gangrene, the skin and tissue around the sore die. The area becomes black and smelly.

To keep gangrene from spreading, a doctor may have to do surgery to cut off a toe, a foot, or a part of a leg. Cutting off a body part is called an amputation.

This answer is based on the source infromation from the National Institute of Diabetes and Digestive and Kidney Diseases.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.