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< All Foot Conditions

Diabetes

Diabetes is a chronic disease which affects many people world wide. It is a condition where insulin (the hormone responsible for metabolizing glucose) function is impaired.

Diabetes is a result of either the body is unable to produce insulin or when the body can only produce insufficient amounts of insulin needed. This results in higher levels of glucose in the blood, which can damage a whole range of body tissues and organs. There are a number of types of diabetes. The most common are:

Type 1
In Type 1 diabetes, the pancreas cannot produce insulin because the cells that actually make the insulin have been destroyed by the body’s own immune system. This insulin must be replaced. Therefore people with Type 1 diabetes must have insulin every day to live.
Type 2
Initially insulin is still produced by the pancreas, but is less effective than normal. This is called insulin resistance and is an inherited characteristic made worse by carrying extra body fat. Because insufficient insulin is available for glucose to move from the blood stream into the body cells and the liver, excess glucose remains in the blood stream resulting in higher than normal blood glucose levels (BGLs).

After several years of diabetes, the pancreas may become "exhausted" and produce less insulin.

Unless blood glucose levels are very high, symptoms may not occur, so many people with type 2 diabetes may not be aware they have diabetes.

Why is the foot of great concern?

The foot is especially affected by diabetes as:

  1. Diabetes damages the nerves leading to peripheral neuropathy. This means that damage can occur to the foot and is unable to be detected which could cause serious consequences. This is called diabetic peripheral neuropathy.
  2. Diabetes affects circulation. Poor circulation affects the ability of the body to heal when damage has occurred and to fight infection. The unfortunate consequence of this is that infections can spread leading to amputation of limbs.
  3. Diabetes affects the joints: it can make them stiffer. A condition called Charcot’s Joints affects diabetic patients, especially if peripheral neuropathy has set in.

Foot Ulcers in People with Diabetes

Foot ulcers are a common complication of the "diabetic foot". They allow a portal for infection to occur. Ulcers are caused by too much pressure on an area of skin which "breaks down". Often times in the diabetic foot they occur under corns and callus. If circulation is impaired, healing can take months to years to occur and it is imperative that pressure be relieved from the area and appropriate wound dressings applied.