What is diabetic foot?
Diabetic foot is a medical term for multiple problems and complications that can happen to people with diabetes. Over time, the high blood sugar levels of diabetes damage nerves and blood vessels. The foot is a commonly affected area that illustrates many of the effects of diabetes on the body.
According to the American Orthopaedic Foot and Ankle Society, the primary symptom seen in diabetic foot is nerve damage (or neuropathy). Neuropathy symptoms include:
- Deformity of the foot—Neuropathy causes paralysis of the small muscles in the feet. The result is that the toes freeze in a clawing position that deforms the natural shape of the foot. This can lead to calluses, water retention between layers of the skin and, ultimately, infection and ulcers.
- Charcot foot—Also known as Charcot arthropathy. Because of the lack of sensation, bones in the foot that are subjected to trauma will fracture and disintegrate. The Charcot foot, when subjected to the stress of walking, becomes deformed into a "rocker" shape with the middle section of the bottom of the foot protruding the most. Symptoms of Charcot foot include swelling of the foot, redness, and changes to the bones. On X-rays, these diabetic foot symptoms may be mistakenly diagnosed as a bone infection, although a bone infection is unlikely if the skin is intact and no ulcer is present.
- Lack of sensation—Nerve damage means you can lose feeling in your feet and not be able to feel a cut, blister or sore. For people without diabetes, these are minor problems, but in diabetics, these can lead to ulcers and infections.
- Poor circulation—Diabetes also damages blood vessels and can prevent your feet from getting adequate blood and oxygen. Without good circulation, it becomes harder for your foot to heal. Symptoms of poor circulation in the diabetic foot are foot sores and infections that are difficult to heal.
- Bone fractures—When people without diabetes fracture a bone in the foot, painful sensations alert them that something is wrong. If you have diabetes, nerve damage in your foot may prevent you from knowing you have a broken bone. As a result, you might continue walking on the injured foot and cause more severe fracture and joint dislocations.
- Pain or tingling in your feet
- Chronic or recurring open wounds or sores
- Redness or pressure in your lower extremities
- Difficulty wearing shoes
- Loss of balance when walking
Treatment options depend on the specific problems. In the early stages of Charcot foot fracture dislocations, the "total contact cast" technique is used successfully to heal diabetic foot ulcers and to protect the foot. For patients with advanced stage Charcot foot, diabetic foot reconstruction surgery is an effective procedure to correct the deformities in the foot and prevent infections.