How does diabetes increase the risk of cracked heels. What are the most effective treatments for diabetic cracked heels. How can diabetics prevent and manage foot complications. Why is proper foot care crucial for people with diabetes. What role does blood sugar control play in preventing diabetic foot problems.

The Connection Between Diabetes and Foot Health

Diabetes significantly impacts various aspects of health, with foot-related complications being a major concern. The condition affects how the body processes blood sugar, leading to potential nerve damage and reduced circulation in extremities. These factors contribute to an increased risk of foot problems, including cracked heels.

Diabetic neuropathy, a common complication of diabetes, can cause loss of sensation in the feet. This decreased sensitivity makes it challenging for individuals to detect injuries or changes in their foot condition. Additionally, poor circulation can impair the body’s ability to heal wounds and fight infections effectively.

How Diabetes Affects Skin Health

Diabetes can alter the skin’s natural moisture balance, leading to dryness and potential cracking. The condition may impact:

• Sweat gland function, reducing natural moisturization
• Skin elasticity and resilience
• The body’s ability to maintain proper skin hydration
• Natural oil production in the skin

These factors collectively contribute to an increased likelihood of developing cracked heels and other foot-related issues.

Understanding Cracked Heels: Causes and Risk Factors

Cracked heels, also known as heel fissures, occur when the skin around the heel becomes excessively dry and forms deep cracks or fissures. While anyone can develop cracked heels, certain factors increase the risk:

• Prolonged standing on hard surfaces
• Wearing open-back shoes
• Obesity, which increases pressure on the heels
• Aging, as skin loses elasticity over time
• Certain skin conditions like psoriasis or eczema
• Nutritional deficiencies

For individuals with diabetes, the risk of developing cracked heels is significantly higher due to the aforementioned complications associated with the condition.

The Role of Blood Sugar Control

Maintaining stable blood sugar levels is crucial in preventing diabetic foot complications, including cracked heels. Uncontrolled blood sugar can lead to:

• Increased nerve damage
• Reduced circulation
• Impaired wound healing
• Greater susceptibility to infections

By keeping blood glucose levels within the target range, individuals with diabetes can significantly reduce their risk of developing foot-related problems.

Identifying and Assessing Diabetic Cracked Heels

Early detection of cracked heels is crucial for effective management and prevention of complications. Common signs and symptoms include:

• Dry, rough skin around the heel
• Visible cracks or fissures in the skin
• Flaky or peeling skin
• Redness or inflammation
• Pain or discomfort when walking
• In severe cases, bleeding or infection

Individuals with diabetes should perform regular foot inspections to identify these signs early. Using a mirror or seeking assistance from a family member can help examine hard-to-see areas of the feet.

When to Seek Professional Help

While mild cases of cracked heels can often be managed at home, certain situations warrant immediate medical attention:

• Deep, painful cracks that bleed
• Signs of infection, such as warmth, redness, or pus
• Persistent pain or discomfort
• Difficulty walking due to heel pain
• Any changes in foot sensation or color

Consulting a podiatrist or healthcare provider promptly can prevent minor issues from escalating into more serious complications.

Effective Treatments for Diabetic Cracked Heels

Managing cracked heels in individuals with diabetes requires a multifaceted approach. Treatment options may include:

Topical Treatments

• Moisturizing creams or ointments containing urea, salicylic acid, or alpha-hydroxy acids
• Medicated foot creams specifically designed for diabetic foot care
• Petroleum jelly or thick emollients to lock in moisture

Gentle Exfoliation

• Use of pumice stones or foot files to remove dead skin (with caution and under professional guidance)
• Soaking feet in warm water to soften skin before gentle exfoliation

Protective Measures

• Wearing moisture-wicking socks to keep feet dry
• Using silicone heel cups or padded insoles to reduce pressure on heels
• Applying liquid bandages or medical-grade super glue to seal minor cracks (under professional supervision)

Professional Treatments

• Debridement of thick, callused skin by a podiatrist
• Prescription-strength moisturizers or medications
• Custom orthotics to address biomechanical issues contributing to heel pressure

It’s crucial for individuals with diabetes to consult their healthcare provider before initiating any new treatment regimen, as some methods may not be suitable for all patients.

Preventive Strategies for Diabetic Foot Care

Prevention plays a vital role in managing diabetic foot health. Implementing the following strategies can help reduce the risk of developing cracked heels and other foot-related complications:

Daily Foot Inspections

• Examine feet daily for any changes, cuts, blisters, or signs of infection
• Use a mirror or ask for assistance to check hard-to-see areas
• Report any concerns to a healthcare provider promptly

Proper Hygiene and Moisturizing

• Wash feet daily with mild soap and lukewarm water
• Dry feet thoroughly, especially between toes
• Apply moisturizer immediately after bathing, avoiding between toes
• Use diabetic-specific foot creams for targeted care

Appropriate Footwear

• Wear well-fitting, supportive shoes with a wide toe box
• Avoid walking barefoot, even indoors
• Choose moisture-wicking socks to keep feet dry
• Rotate shoes regularly to allow them to dry completely between wears

Lifestyle Modifications

• Maintain a healthy diet rich in vitamins and minerals essential for skin health
• Stay hydrated to support overall skin moisture
• Engage in regular, low-impact exercise to improve circulation
• Avoid prolonged standing or sitting in one position

By incorporating these preventive measures into daily routines, individuals with diabetes can significantly reduce their risk of developing cracked heels and other foot-related issues.

The Importance of Regular Podiatric Care

Regular visits to a podiatrist are essential for individuals with diabetes, even in the absence of apparent foot problems. These specialists can provide:

• Comprehensive foot examinations
• Early detection of potential issues
• Professional nail and callus care
• Custom orthotics or shoe recommendations
• Education on proper foot care techniques

Podiatrists can also assess an individual’s overall foot health and provide personalized advice on managing diabetes-related foot complications.

Frequency of Podiatric Visits

The recommended frequency of podiatric visits may vary depending on an individual’s risk factors and overall foot health. Generally:

• Low-risk patients: Annual check-ups
• Moderate-risk patients: Every 3-6 months
• High-risk patients: Every 1-3 months or as recommended by the podiatrist

Adhering to these recommended schedules can help prevent minor issues from escalating into more serious complications.

Nutritional Considerations for Healthy Skin

Proper nutrition plays a crucial role in maintaining healthy skin and preventing complications like cracked heels. For individuals with diabetes, focusing on a balanced diet can support overall foot health and aid in managing blood sugar levels.

Essential Nutrients for Skin Health

Incorporating the following nutrients into the diet can promote skin elasticity and moisture retention:

• Omega-3 fatty acids: Found in fatty fish, flaxseeds, and walnuts
• Vitamin E: Present in nuts, seeds, and vegetable oils
• Vitamin C: Abundant in citrus fruits, berries, and leafy greens
• Zinc: Found in lean meats, seafood, and legumes
• Biotin: Present in eggs, nuts, and sweet potatoes

Consulting with a registered dietitian can help create a personalized meal plan that addresses both diabetes management and skin health needs.

Hydration and Skin Health

Proper hydration is essential for maintaining skin moisture and elasticity. Individuals with diabetes should:

• Drink adequate water throughout the day
• Limit caffeine and alcohol intake, which can contribute to dehydration
• Consume water-rich foods like cucumbers, watermelon, and zucchini

Maintaining proper hydration not only supports skin health but also aids in overall diabetes management.

Managing Complications and Emergencies

Despite preventive measures, complications may still arise. Knowing how to manage emergencies and when to seek immediate medical attention is crucial for individuals with diabetic foot issues.

Recognizing Foot Emergencies

Certain symptoms require urgent medical care:

• Sudden, severe pain or swelling in the foot
• Changes in skin color, especially if accompanied by pain
• Open sores or wounds that don’t heal
• Signs of infection, such as redness, warmth, or pus
• Fever or chills in conjunction with foot problems

In these cases, seeking immediate medical attention can prevent potentially serious complications.

First Aid for Minor Injuries

For minor cuts or blisters:

• Clean the area gently with mild soap and water
• Apply an antibiotic ointment if recommended by a healthcare provider
• Cover the area with a sterile bandage
• Monitor closely for signs of infection
• Seek professional care if the wound doesn’t show signs of healing within a few days

It’s important to note that even minor injuries should be taken seriously in individuals with diabetes due to the increased risk of complications.

Emerging Treatments and Research

The field of diabetic foot care is continually evolving, with new treatments and technologies emerging to address complications like cracked heels. Some promising areas of research include:

Advanced Wound Healing Techniques

• Growth factor therapies to accelerate wound healing
• Bioengineered skin substitutes for treating chronic ulcers
• Negative pressure wound therapy for managing complex wounds

Innovative Footwear Technologies

• Smart insoles that detect pressure points and temperature changes
• Custom 3D-printed orthotics tailored to individual foot shapes
• Shoes with built-in sensors to alert users of potential issues

Novel Topical Treatments

• Nanoparticle-based moisturizers for enhanced skin penetration
• Stem cell therapies for promoting skin regeneration
• Advanced hydrogel dressings for maintaining optimal wound moisture

While many of these treatments are still in development or early stages of clinical use, they offer hope for improved management of diabetic foot complications in the future.

The Role of Patient Education and Self-Management

Empowering individuals with diabetes to take an active role in their foot care is crucial for preventing and managing complications like cracked heels. Effective patient education programs can significantly improve outcomes and quality of life.

Key Components of Diabetic Foot Education

Comprehensive education should cover:

• The importance of daily foot inspections
• Proper foot hygiene and moisturizing techniques
• Appropriate footwear selection
• Blood sugar management and its impact on foot health
• Recognition of early warning signs and when to seek medical attention
• Lifestyle modifications to support overall foot health

Self-Management Tools and Resources

Various tools can aid in effective self-management:

• Diabetes management apps with foot care reminders and tracking features
• Educational videos demonstrating proper foot care techniques
• Support groups for individuals with diabetic foot concerns
• Telemedicine consultations for remote foot assessments

By actively engaging in self-management and utilizing available resources, individuals with diabetes can significantly reduce their risk of developing serious foot complications.

In conclusion, managing diabetic cracked heels requires a multifaceted approach involving proper foot care, regular medical check-ups, and lifestyle modifications. By understanding the connection between diabetes and foot health, implementing preventive strategies, and staying informed about emerging treatments, individuals can effectively manage this common complication and maintain overall foot health. Regular communication with healthcare providers and active participation in self-management are key to achieving the best possible outcomes in diabetic foot care.

The Link Between Diabetes and Cracked Heels

Cracked heels, also known as heel fissures, is a common and unsightly condition that negatively impacts the wellness of your feet. Simply put, this condition occurs when the skin surrounding the heel and bottom of the feet becomes exceedingly dry. This skin can crack, causing fissures. In many cases, this condition is harmless. However, cracked heels can be unattractive and, in severe cases, might lead to infection and swelling. If you are diabetic, you stand at an increased risk of suffering from cracked heels. This is because diabetes can make your feet dry and deprive the skin of necessary nutrients, making cracked heels more likely. Additionally, in some cases, diabetes can damage the nerves present in one’s feet, which can prevent sweat glands in the feet from releasing sweat. The deprivation of sweat can reduce the moisture in the feet, increasing the probability of the onset of cracked heels. Therefore, while cracked heels are not necessarily a sign of diabetes, diabetics can face an increased risk of suffering from this affliction. If you are a diabetic and want to protect yourself from cracked heels, consider contacting a podiatrist.

Cracked heels are unsightly and can cause further damage to your shoes and feet. If you have any concerns, contact one of our podiatrists from Foot Surgery Specialists of Texas. Our doctors can provide the care you need to keep you pain-free and on your feet.

Cracked Heels

Cracked heels appear unappealing and can make it harder for you walk around in sandals. Aside from looking unpleasant, cracked heels can also tear stockings, socks, and wear out your shoes. There are several methods to help restore a cracked heel and prevent further damage.

How Do You Get Them?

Dry skin is the number one culprit in creating cracked heels. Many athletes, walkers, joggers, and even swimmers suffer from cracked heels. Age and skin oil production play a role to getting cracked heels as well.

Promote Healing

Over the counter medicines can help, especially for those that need instant relief or who suffer from chronic dry feet.

Wear Socks – Wearing socks with medicated creams helps lock in moisture.

Moisturizers – Applying both day and night will help alleviate dryness which causes cracking.

Pumice Stones – These exfoliate and remove dead skin, which allows for smoother moisturizer application and better absorption into the skin. 

Change in Diet

Eating healthy with a well-balanced diet will give the skin a fresh and radiant look. Your body responds to the kinds of food you ingest. Omega-3 fatty acids and zinc supplements can also revitalize skin tissue.

Most importantly, seek professional help if unsure how to proceed in treating cracked heels. A podiatrist will help you with any questions or information needed. 

If you have any questions, please feel free to contact our offices located in River Oaks and Sharpstown in Houston, TX . We offer the newest diagnostic and treatment technologies for all your foot care needs.

How to treat cracked heels with diabetes

Diabetes can lead to skin changes on the feet, including cracked heels. Without treatment, infections and other complications can arise. Tips for protecting the feet include regular checking, moisturizing, and wearing appropriate footwear.

Diabetes describes several conditions that affect how the body processes and maintains its blood sugar level. If a person has a difficult time keeping their blood sugar within a stable range, they may experience complications that can include foot problems, such as cracked heels.

Cracked heels, also known as heel fissures, refer to hard, dry skin forming over the heels of the feet. This can cause discomfort and may lead to health complications, such as slow-healing wounds and infections.

In this article, we discuss how diabetes affects the feet, how to treat cracked heels, and how to manage other common foot health concerns that may occur with diabetes.

An unstable blood sugar level can lead to nerve damage and a circulation decrease.

Nerve damage can result in a person losing sensation in their feet. This may make it harder for a person to notice wounds, such as blisters, on their feet. As such, a person may not treat some wounds, so these cuts and sores may have a higher infection risk.

Damage to the nerves can also impact how the body keeps its natural oils and moisture in the feet. This may make it more difficult for a person to feel the formation of hard, thick sections of skin. Therefore, a person with diabetes may be more likely to develop dry and cracked skin.

Usually, a healthy blood flow delivers sufficient nutrients and immune cells to a wound, which encourages healing and prevents infections. However, as diabetes can affect circulation, it causes blood to move more slowly, which means the body may have difficulty healing the wound or stopping an infection.

Additionally, a decrease in circulation can result in changes to the skin of the feet and lead to the formation of calluses.

The American Academy of Dermatology Association (AADA) recommends the following options to help treat cracked heels at home and prevent them from coming back. These suggestions include:

• Taking shorter baths and showers: Bathing for too long can make skin dry out, which can worsen cracked heals. It is also advisable to gently blot the skin dry using a towel.
• Using a gentle cleanser: This can help the skin on the heels retain their natural oils and prevent dry skin.
• Moisturizing after bathing: Applying a moisturizer to the heels immediately after bathing, when the skin is still damp, can lock in moisture. People may consider using moisturizers that contain urea, alpha hydroxy acid, or salicylic acid.
• Applying petroleum jelly before bed: Applying a layer of plain petroleum jelly and wearing socks before bed can help heels maintain moisture.
• Protecting the heels: People may consider using a liquid bandage during the day to create a protective barrier over the heel. This can help reduce pain, speed up healing, and prevent pathogens from entering the skin.
• Wearing proper footwear: Wearing appropriate footwear can provide the feet with suitable support and reduce pressure on the heel. As such, people may want to avoid open-heeled shoes, such as flip flops.

In more severe cases, or if a person notices no improvement, it is advisable for them to contact a podiatrist. This term refers to an individual who specializes in the medical care and treatment of the foot.

A podiatrist can provide advice on looking after the feet and can offer more effective treatment options, which may include debridement or stronger softening or debriding agents.

Learn more about treating cracked heels.

Foot health complications that a person with diabetes may experience include:

• Neuropathy: This refers to a potential complication of diabetes that results in nerve damage. This can lead to a person losing sensation in their feet, making it difficult to feel cuts or sores that can worsen and result in further complications.
• Circulation decrease: A decrease in blood flow to the feet can cause injuries to heal slowly or not heal at all, making it harder for the feet to clear infections.
• Foot ulcers: This refers to slow-healing wounds that commonly affect the feet of people living with diabetes. Without proper management, an ulcer can undergo necrosis and become gangrenous.
• Amputation: In severe cases, when wounds do not heal on the foot, a doctor may need to surgically remove the limb.

The Centers for Disease Control and Prevention (CDC) provides tips to keep feet healthy, including:

• Checking feet regularly: By checking the feet every day for any cuts, discoloration, sores, or other changes to the feet, a person can appropriately treat the health concern before it gets worse.
• Washing feet: It is important to wash, dry, and moisturize the feet to keep them clean and hydrate them.
• Avoiding going barefoot: To help prevent potential injuries to the feet, it is advisable to always wear footwear, such as shoes, socks, and slippers.
• Wearing well-fitting shoes: By wearing comfortable shoes that provide appropriate support, people can avoid injuries to their feet, such as blisters.
• Trimming nails carefully: It is advisable that people trim toenails straight across and keep them short. Rounded nails can grow inward, leading to infection.
• Caring for corns and calluses: It is important to treat corns and calluses carefully because if a person attempts to remove them themselves, this could cause injury.
• Regular foot exams: In addition to regularly connecting with other members of the diabetes healthcare team, a person may want to consider attending podiatry appointments so that a doctor can check their feet.
• Regular physical activity: Keeping physically active supports adequate blood flow to the feet, which can help avoid foot health concerns. A person can consider feet-friendly activities, such as walking, biking, or swimming.

Additionally, it is important for a person to try to manage their blood sugar and keep it within a stable range. A person can reduce the risk of foot health complications from diabetes by:

• checking blood glucose levels regularly
• taking diabetes medication
• maintaining a moderate weight

Potential complications of diabetes can include a circulation decrease and slow wound healing. This means a person living with diabetes may be at a higher risk of foot health concerns, such as cracked heels. Without appropriate treatment, cracked heels can become painful and develop infection.

Therefore, to prevent cracked heels and potential complications, it is important for a person with diabetes to try following foot care tips, such as checking their feet regularly, moisturizing, and wearing well-fitting shoes.

Skin lesions in diabetes

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Diabetes is a chronic disease that has a negative impact on the entire human body. Often the life of people living with diabetes is complicated not only by the need to constantly monitor the level of sugar (glucose) in the blood, damage to the eyes, kidneys, cardiovascular system, but also by various skin disorders. With a severe course of the disease, it becomes rough to the touch, its turgor decreases, significant peeling develops, especially of the scalp. Hair loses its shine. Calluses and cracks appear on the soles and palms. Often develops a pronounced yellowish coloration of the skin. Nails are deformed and thickened.

Some dermatological manifestations can act as “signals” of an undiagnosed diabetes mellitus. As a rule, the disease is indicated by skin itching, dryness of the mucous membranes and skin, recurrent skin infections (candidiasis, pyoderma), diffuse hair loss.

The etiology of skin lesions in diabetes is certainly associated with disorders of carbohydrate metabolism. To prevent the development of complications, patients need to constantly monitor their blood sugar levels. The closer this indicator is to “non-diabetic”, the less likely the occurrence and development of complications.

Diabetic dry skin

When blood sugar (glucose) is elevated, the body of a diabetic produces excess urine and loses fluid. This means that the skin is also dehydrated: the skin becomes dry and flaky. The work of the sebaceous and sweat glands is disrupted. Unpleasant itching occurs, cracks form, and the risk of developing skin infections increases.

Good skin hygiene helps prevent skin lesions. But conventional cosmetics, such as toilet soap, are not suitable for diseased skin: it lowers the acidity of the skin, reducing its resistance to microbes. Therefore, wash, wash hands and feet should be pH-neutral soap. And the face is generally better to clean with water lotions or cosmetic milk.

Great attention should be paid to the skin of the hands and feet. Maintaining the cleanliness of the skin, the use of special moisturizing and softening cosmetics is a necessary daily procedure for diabetics. The most effective are cosmetic products containing urea.

Diabetic hyperkeratosis

Hyperkeratosis (excessive callus formation) is one of the main causes of diabetic ulcers. When wearing tight shoes, constant pressure on a certain spot can cause calluses to form. They usually occur on the sole (corns), on the upper surface of the finger, sometimes on the lateral side and in the interdigital space. The resulting callus presses on the skin, causing a hemorrhage under it, which can subsequently lead to the formation of a trophic ulcer. Dryness of the skin of the heel area leads to its keratinization, the appearance of cracks, which cause a lot of inconvenience when walking and can also become infected.

Patients with diabetes should wear comfortable, ideally special orthopedic shoes to avoid foot deformity, blisters and abrasions. In no case should a callus that has already formed be cut off or steamed out in hot water. It is forbidden to use corn liquid and patches. The means of choice in such cases are special softening and moisturizing creams containing a large amount (about 10%) of urea. It is best to use them 2-3 times a day: apply to clean skin, preferably after pumice treatment, and make sure that the cream does not get into the area between the fingers.

Trophic ulcers in diabetes mellitus

Diabetic ulcers appear when infected wounds have not been properly treated. With the formed trophic ulcers, patients with diabetes mellitus are treated in the office of the “Diabetic foot”. The general principles of treatment are the use of modern dressings (alginates, polyurethane foam dressings, hydrogels, etc.), regular treatment of the wound with alcohol-free antibacterial agents and the competent use of antibiotics.

Infection of cuts and small skin lesions in diabetes mellitus

Patients with diabetes often develop skin infections at the sites of insulin injections and blood sampling. Small skin cuts when cutting nails can also become the entrance gate of infection. Due to impaired nerve conduction (diabetic neuropathy), diabetic patients have reduced pain sensitivity, and even serious skin damage can go unnoticed, which will eventually lead to infection. Therefore, patients with diabetes pay considerable attention to the condition of the skin, undergo special training under the program “Diabetic foot”.

For the treatment of small wounds, under no circumstances should the use of alcohol-containing solutions (iodine, brilliant green) or potassium permanganate solution be recommended. It is best to treat with hydrogen peroxide, furatsilin, chlorhexidine or apply special cosmetics containing antibacterial components. If signs of inflammation appear (its signs are redness, swelling, soreness), the patient should immediately see a doctor.

Fungal infection of nails and skin (mycosis) in diabetes mellitus

The source of fungal infection is the contact with the skin of pathogens of mycoses. The weakening of the immune defense in diabetic patients leads to the fact that the fungus begins to actively multiply. Fungal infections in patients with diabetes occur more than 2 times more often than in healthy people.

Mycosis of the nail plate (onychomycosis) is manifested by a change in the color of the nail, its thickening or delamination. The thickened toenail puts extra pressure on the toe in the shoe, which can result in a diabetic ulcer. To reduce the thickness of the nail, patients with diabetes regularly perform mechanical processing of the plate: polishing with a file or pumice stone.

Itching, irritation in the folds of the skin or in the space between the fingers indicate the presence of a fungal infection of the skin. To prevent the occurrence of skin mycoses, patients can be recommended to use daily cosmetic creams containing fungicidal and antibacterial complexes. Fungal infections are perfectly treated with modern drugs, both oral and topical, provided that they do not increase the moisture between the fingers.

Patients with diabetes are characterized by increased sweating, thermoregulation disorders, especially in the folds of the skin, resulting in diaper rash. To prevent the development of a fungal infection, places with diaper rash are recommended to be treated with talc or prophylactic creams containing zinc oxide.

Diabetic Foot Syndrome

It is common knowledge that people with diabetes are at a significantly higher risk of foot problems than other people. Diabetic foot syndrome (DFS), a complex of purulent-destructive lesions of the lower extremities in diabetes, is one of the serious complications of diabetes mellitus, often leading to leg amputation. Quite eloquently this is evidenced by at least the fact that the risk of developing foot gangrene in patients with diabetes is 10-15 times higher.

If the peripheral nerve endings are damaged, the skin of the legs will no longer feel pain, temperature changes, and touch. This poses a high risk of injury. The patient can step on a sharp object, get burned, rub his leg – and not feel it. Violations of capillary blood flow (microangiopathy) dramatically reduce the ability of the wound to heal.

The manifestations of SDS include: trophic ulcers; chronic, long non-healing purulent wounds; foot phlegmon; osteomyelitis of the bones of the foot; gangrene of one or more fingers, the entire foot or part of it. The treatment of a diabetic foot is very complex and costly, often patients come to the doctor already at such a stage of development of the complication that only amputation can save a life. Therefore, it is very important that patients know that early contact with a doctor, prevention of skin lesions and foot care are necessary measures to prevent disability.

Foot care for diabetics differs significantly from normal hygiene for people without diabetes. The main point in the treatment of diabetic foot is the correction of blood sugar levels, so the treatment is usually carried out by a surgeon together with an endrinologist. It is almost impossible to achieve good results in the treatment of infectious skin diseases without correction of carbohydrate metabolism.

Special rules for foot care have been developed for patients, and there are offices or departments of the “Diabetic Foot” in polyclinics.

Today, diabetics can find everything they need for special skin care in pharmacies. A sufficient choice of expensive imported and effective, but affordable Russian products will help make thorough skin care for diabetes a good habit, improve the quality of life of patients and avoid the development of a number of serious complications

Diabetic foot: causes, symptoms, treatment methods

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One of the most serious global health problems is diabetes mellitus, a chronic endocrinological disease caused by a lack of the hormone insulin in the body.

According to statistics from the World Health Organization (WHO), approximately 500 million people worldwide have been diagnosed with diabetes. Every year the incidence rate is growing – over the past 40 years, the number of registered cases has increased 4 times.

In addition to the fact that the disease itself is a dangerous disease for a person, it often leads to serious consequences. One of the most difficult consequences of diabetes is the disease Diabetic foot.

Description of manifestations “Diabetic foot”

Diabetic foot syndrome (diabetic foot or DFS) is a complex of complications of diabetes mellitus. This is a dangerous disease that is formed in people with diabetes and involves the process of damage to the epidermis, dermis, bones, nerve endings on the feet; with untimely or absent treatment, loss of a leg is possible.

According to statistics, every tenth person diagnosed with DM (diabetes mellitus) is diagnosed with the disease Diabetic foot, 50% of diabetics are at risk.

Diabetes mellitus implies a malfunction in the functioning of the nervous, vascular systems, which leads to disorders associated with blood supply and nervous regulation of the extremities. These disorders are the cause of the disease SDS.

In the initial stages, the main symptoms of the disease are superficial ulcerative lesions on the feet, in later stages the ulcers penetrate deeper, affecting muscles, tendons, and bones. In the last stages, a limited and then extensive gangrene is formed.

The main methods of treatment for diabetic foot are the normalization of blood sugar, local treatment of the skin and nail plates, drug therapy, and surgical interventions.

Diabetic foot belongs to the category of those diseases, the treatment of which absolutely cannot be delayed! Gangrene, general blood poisoning, amputation, death of the patient are the real consequences of inaction. Therefore, you should contact the experts immediately.

Which doctor to contact

An endocrinologist and a surgeon are the doctors you should definitely contact when the first signs of a diabetic foot appear. Often, treatment requires an integrated approach; both a vascular surgeon, a neurologist and an endocrinologist, as well as an orthopedist, traumatologist, dermatologist and podologist can take part in it.

It is necessary to take a number of measures and prescribe a comprehensive treatment in order to return a person to a comfortable life and painless mobility.

Causes of disease

Violation of normal blood circulation is the main cause of the disease. Patients with diabetes have elevated blood glucose levels, which inevitably causes metabolic disturbances, which leads to damage to the blood vessels of the extremities and deterioration of blood supply to tissues.

First of all, the blood supply to the distal parts of the lower extremities is disturbed. There is insufficient nutrition of the cells of the nerve endings, so irreversible changes occur – the nerve cells die, the lower limbs lose their sensitivity.

The feeling of pain weakens, as a result, small wounds, calluses, abrasions that appear on the feet do not cause pain, so they may not heal for a long time, grow and increase in size, and bacteria and viruses that enter cause suppuration.

Thus, the main causes of DFS are circulatory disorders due to high blood glucose (hyperglycemia) and nerve damage (neuropathy) of the lower extremities . Further development of the disease is caused by causes associated with damage to the skin of the feet:

• wearing tight, uncomfortable shoes that can lead to calluses, corns, and other skin lesions;
• injuries, scratches, abrasions, insect bites and other mechanical damage to the skin;
• small cuts and wounds resulting from a pedicure;
• ingrown nails;
• cracked feet;
• fungal diseases.

Diabetic foot symptoms. Disease stages.

People with diabetes need to be as attentive and sensitive to their own health as possible. At the first changes in the state of health and well-being, it is advisable to consult a specialist. The feet are a part of the body that also requires increased attention.

You are advised to contact your doctor if you experience any of the following symptoms:

• crawling sensation in the legs
• numbness of the lower extremities, their tingling
• burning sensation in legs
• occurrence of cramps in the calves
• hair loss in the lower legs
• the appearance of pigmentation on the legs or discoloration (blanching, redness, blue)
• darkening of the nail plate (bruising under the nail plate)
• cracking of the feet
• weeping eczema between fingers (small blisters with clear liquid inside)
• Leg injuries heal slowly or do not heal at all
• itching
• edema formation
• peeling, dry skin

Symptoms of SDS may also include increased fatigue, as well as pain in the legs at night and during walking.

SDS stages

In medicine, several stages of the disease are defined:

Zero or initial stage :

• deformity of the bone structure of the foot
• callus formation
• skin color pale
• itching may occur without visible damage to the skin

The most important task of this stage is to prevent damage, because any wound on the feet is the prospect of developing an ulcer. It is necessary to provide maximum skin care, and, if possible, do not burden the feet.

First stage :

• ulceration and cracking of the skin of the feet
• darkening of the nail plate, possible ingrown nails
• thumb bones are deformed
• wounds, abrasions and cuts do not heal for a long time

Lesions are superficial – bones, tendons, muscles are not damaged.

At this stage it is necessary to prevent infection of the wound. It is important to keep the wound clean and speed up the healing process.

Second stage :

• wounds become deeper
• ulcer begins to affect subcutaneous tissues, muscles, tendons
• when the wound becomes infected, swelling, redness, pus appear

Deep tissue and bone lesions in the second stage have not yet been diagnosed. The wound can be either infected or uninfected.

The main task in the second stage is to remove dying tissues, thereby avoiding suppuration.

Third stage :

• lesions become deeper, bones, joints are affected
• osteomyelitis develops (an inflammatory process in which all elements of the bone are affected)
• an abscess develops (purulent inflammation)

Fourth stage :

• the process of gangrene formation (death of living tissues) begins

First, the area of ​​the fingers turns black (starts from the tips), then the supporting part is affected. The limb can be saved with surgery.

Fifth stage :

• Gangrene continues to spread throughout the foot, rising to the lower leg.

Areas with affected tissue increase, the only way out at this stage is amputation of the limb.

The fifth stage of the disease is extremely dangerous and life threatening.

Diagnosis of DFS is statistically the most common reason for amputation. It is important for diabetics to remember that it is necessary to follow the rules for the prevention of SDS, and at the first suspicion, immediately consult a doctor.

Varieties of diabetic feet

In medicine, three varieties are distinguished – these are ischemic diabetic foot, neuropathic and mixed (ischemic-neuropathic or neuroischemic).

Ischemic type of DS

Ischemic DS (caused by circulatory and blood supply disorders): with this type of diabetic foot, blood vessels are affected, tissue deficiencies form, swelling, pigmentation and pain appear during walking.

Symptoms that are observed in the ischemic form of DFS:

• severe leg fatigue
• edema
• weak or absent pulse in the feet
• feet cold and pale
• pigmentation
• dry feet
• calluses that do not heal for a long time
• further development of painful ulcers

Neuropathic DS

The neuropathic variety is diagnosed more often than others, the cause is damage to the nerves of the lower extremities. With this variety, the patient has a deterioration in the sensitivity of the feet. Calluses and other injuries of the feet do not bring discomfort when walking, this leads to their long-term healing.

Symptoms characteristic of the neuropathic form of DFS:

• decreased thermal and tactile sensation in the legs
• reduced reflexes
• feet are warm, pulsation is present
• deformity of joints and fingers
• development of flat feet
• Painless sores on the feet (usually between the toes)

Mixed DS

This variety is characterized by disturbances in the functioning of the vascular and nervous systems of the lower extremities. With a mixed form, signs of both ischemic and neuropathic forms can be observed.

Complications of diabetic foot

DFS disease is characterized by impaired blood supply and metabolism of the tissues of the foot, which is a serious threat to the rapid healing of wounds. Often, the resulting microtraumas go unnoticed, because. do not cause inconvenience and pain.

Calluses, abrasions, wounds from foreign objects that got into the shoes or received during the processing of nails do not heal for a long time. A long time non-healing affected area is an excellent breeding ground for bacteria, infections and fungi.

Complications of a diabetic foot are extremely sad – there is a risk of developing trophic ulcers, gangrene and further deprivation of a limb. According to statistics, this happens in 20% of cases of SDS.

Main complications of DS : skin and bone necrosis, deformities of bones and joints, ulcers, gangrene.

Infections

Any abrasions take a very long time to heal and there is a high risk of infection.

It is unacceptable to ignore doctor’s appointments! At an early stage, you need to contact a podiatrist.

Foot deformity

Damage to the nerves of the lower extremities leads to a decrease in the motor activity of the muscles and their atrophy. Muscle tone becomes weak, which affects the musculoskeletal system of the limbs – the fulcrum changes, the correct distribution of weight is disturbed; such violations lead to the development of flat feet and changes in the ankle joint. The patient has changes in gait – lameness appears.

Charcot’s arthropathy is a severe complication associated with foot deformity.

Charcot’s foot is a rare rapidly developing severe complication of DM, which is associated with the destruction of the soft tissues of the feet and joints; there is a deformation of the shape of the foot and the formation of trophic ulcers in places of high pressure on the foot; full support on the leg is impossible.

Ulcers

In 20% of people with DM, there is a complication such as trophic ulcers, and the usual wear from shoes can cause it. Often, it is long-term non-healing wounds that become the reason for going to the doctor and further diagnosing diabetes mellitus.

Ulcers are mostly the result of self-treatment!

It is very important to start treatment on time, as the wound does not heal on its own, spreads deeper, necrosis processes begin.

Independent and timely diagnosis of ulcers is difficult, because symptoms do not appear until the moment of infection – until swelling, an unpleasant odor, irritation and itching appear.

Gangrene

Gangrene is the necrosis of the tissues of a living organism. Tissue cells die, the skin turns black. To stop the spread of infection throughout the body and to save lives, amputation of a limb is performed.

According to statistics, within five years after amputation, amputation of the second limb is performed in 50% of cases.

It is possible to save a leg in rare cases and in the first stages of the disease, the only way is to restore blood circulation in the limbs.

For people with diabetes, regardless of the stage and form of the disease, self-monitoring and strict care are extremely important! Constant monitoring of blood glucose levels, thorough daily examination and foot care will reduce the risk of dangerous complications by half!

Diagnosis and treatment of diabetic foot

First of all, doctors need to study the history of the course of the underlying disease – diabetes mellitus; in addition to the study of the medical history, a survey and examination of the patient is carried out.

To determine the tactics of treatment, a number of studies are needed:

• Detailed medical history (information about the patient and the development of the disease): the duration of the disease, the presence of ulcers, previous treatment, visual condition, the presence or absence of pain, the period of their manifestation, etc.
• Examination of the legs: color of the skin and nails, the presence of flat feet, deformities of the fingers, the presence of edema, cracks, thickening of the skin, etc.; inspection of both extremities is obligatory.
• Assessment of blood flow by arterial palpation
• study of diabetic neuropathy: assessment of subjective (pattern of pain, tingling, burning, chilliness, decreased sensation) and objective (muscle strength, reflexes, etc.) symptoms. To assess the functions of the peripheral nervous system, electroneuromyography (ENMG) is performed – a modern research method that allows you to diagnose the state of the nervous system.
• study of macroangiopathy (changes in the arteries that develop against the background of diabetes mellitus): assessment of blood flow using ultrasound duplex scanning of vessels (USDS) and radiopaque angiography. Ultrasound allows you to visualize a blood vessel, examine its condition and blood flow. Angiography is the main method for assessing vascular damage and the state of blood flow.
• Investigation of the state of bone structures: assessment of the state of bone tissue using radiography. If necessary, an MRI (magnetic resonance imaging) examination is possible.
• Blood test and bacteriological examination of discharge from wounds. Studies are needed to determine the severity of the inflammatory process and the selection of effective antibiotic therapy.

Treatments for diabetic foot

• Antibacterial therapy: bactericides, antibiotics, antiseptics. The choice of drugs and the duration of treatment depends on the results of a blood test and a bacteriological examination of the contents of the wound
• Surgical treatment of ulcers: removal of damaged tissue
• Unloading the affected limb: use of special devices and dressings
• therapeutic measures to improve blood flow
• Physiotherapeutic methods: most often performed after surgical treatment for the purpose of rehabilitation and include magnetotherapy, phototherapy, UHF therapy, etc.

The main rules that every patient with diabetes should know are the refusal of self-medication, timely access to a doctor and an integrated approach. Control of blood counts, medical procedures and timely access to a specialist will help to avoid disastrous consequences.

Diabetes Prevention

Prevention of diabetic foot syndrome is essential for patients diagnosed with diabetes mellitus.

Required action:

• Continuous blood sugar monitoring
• Daily foot check
• quit bad habits (smoking, alcohol)
• refusing to go barefoot, even at home
• Special Therapy Orthopedic Shoes
• Maximum possible protection against burns and cold feet
• Power normalization
• Performing therapeutic and breathing exercises (to improve the state of the cardiovascular system, normalize body weight, improve lymph flow)
• regular medical examinations
• Self-treatment exception

Remember that it is much easier to prevent the development of DFS than to cure it.