The Diabetic Foot

Daniel A. Weisz - Podiatrist

http://www.wisepodiatry.co.uk/

In this article I would like to explain to you what a "Diabetic" foot

means and why it needs to be taken care of.

In a generally healthy person, the concentration of insulin in the

circulation is balanced and serves to preserve a constant amount of
glucose in the blood - about 90 mg/100 cc of blood. A lack of insulin
causes the breakdown of fats and proteins in the muscles causing
weight loss despite increased food intake. The automatic increase in
blood pressure resulting from this causes the blood to absorb water
from the body tissues and dry them out. The water in the blood is
taken up by the kidneys and the blood becomes more viscous (higher
concentration of red blood cells) thus interfering with blood flow and
disrupting the circulatory system. The inadequate circulation has
visual repercussions that may lead to blindness, loss of sensation in
the hands and feet sometimes resulting in necrosis, slow healing of
wounds, and frequent infections.

Diabetic lower limb

The term 'diabetic foot' describes the foot of the diabetic. The blood
circulation in such a foot is frequently disturbed, the skin dries out
and may become scaly. This is a foot at risk. The risk is of
development in the diabetic of a sore or ulcer on the foot, which fails
to heal. One of the factors that enhance this risk in diabetics is the
frequent loss of nervous sensation in the feet. In such cases, any
injury to the foot will not be felt by the patient. He will not feel pain,
heat or cold which would cause a healthy person to withdraw from the
offending stimulus. A diabetic who steps on a nail may not feel pain,
and he may be exposed to further injury. In addition, the blood
vessels in the limbs of diabetics are affected and the flow of blood
bringing oxygen to the wound is slowed down - oxygen is vital for
rapid wound healing. Moreover , the white blood cells reaching the
wound are also depleted, contributing to slower wound healing. As a
result, blisters and ulcers appear, and infection, inflammation and
edema may develop, all leading to further interference with blood
flow, and so on. Thus , in many cases even slight wounds may
become infected and may develop into severe foot ulcers and
necrosis. Many diabetics reach a condition where several toes, or
even the whole lower leg, from the knee down, may necessitate
amputation. About 55%of all amputations in Israel that do not result
from injury have their origin in diabetes.

Prevention of wounds and acceleration of healing: the best treatment

for the diabetic foot is preventing occurrence of the offending wound.
Diabetics should be encouraged to examine the condition of their
feet, and should consult a foot physician at least twice a year. They
should pay special heed to foot hygiene, wear appropriate socks and
shoes, combined with effective soft insoles, designed especially for
diabetics. It is essential that they tread on smooth. Soft surfaces
adapted to their personal needs. There is a lack of awareness among
diabetics in Israel regarding the subject of insoles. A large number of
amputations could be avoided by consistent use of these appliances.
Statistics

Diabetes is a rising health problem today throughout the world. In the

united states today, there are 16 million diabetics, and about 8 million
more undiagnosed cases. Every day, about 1700 cases of both types
of diabetes are diagnosed. Diabetes is the 7th most frequent cause of
death in the USA, and the chief cause of blindness. In Israel there are
and estimated 250,000 diabetics. The life expectancy of diabetics is
about 15 years shorter than that of the healthy population. Correct
control and treatment contribute to the quality of life of the patients.

So, come join us, and take your feet in hand...

Diabetes and other high risk diseases may affect the nervous system
and lead to loss of sensation in the feet. Narrowing of the blood
vessels result in an inadequate blood flow to peripheral parts of the
body, these slowing down wound healing.

Stress, blows, ingrown toenails, blisters or objects falling on the foot

may cause trauma, injury or infection , and may even necessitate
hosptalization.

The information presented here is vital to foot health. It is crucial for

us and for you to be aware of the importance of adequate foot
treatment and of the adverse results of not heeding the
recommendations in this presentation. We prepared the information
to answer some of your questions and provide you with the necessary
knowledge for appropriate care of your feet.

Daily foot care

1. Wash your feet with warm water and soap (do not soak them for
prolonged periods). 2. Do not use hot water - test the temperature by
hand or with the elbow' to avoid burns. 3. Dry them thoroughly -
especially between the toes. 4. Apply ointment or cream. 5. Examine
your feet (if you cannot see them yourself, ask for assistance of use a
mirror).
If you encounter a problem or change in the condition of your feet, do
not try to treet it alone - visit a nurse at clinic.

When should you visit a foot clinic urgently? You should contact a
physician or a clinic immediately if you see any infection around the
nails. On the foot or the calf. Many patients think they can deal with
such 'small' problems on their own. This mistake could result in the
loss of the foot and endanger your life!