One of the most devastating side effects of diabetes mellitus is the peripheral neuropathy that eventually develops when the disease is uncontrolled. Peripheral neuropathy is loss of partial or complete sensation to the extremities. In diabetics it most commonly begins in the feet and is characterized by numbness, tingling, prickling, and sometimes even a burning sensation. Peripheral neuropathy places you at a greater risk for developing ulcers on your feet because you cannot feel when you step on sharp objects. Complete peripheral neuropathy is also often a sign of a more advanced stage of disease. Therefore, your immune system’s response to healing even the smallest of wounds is diminished. That’s why it is important to keep a step ahead of ulcers by preventing them from occurring in the first place.
So what is an ulcer anyway? It is a wound that penetrates through both the epidermal and dermal layers of the skin.
In addition to stemming from puncture wounds caused by stepping on sharp objects, ulcers are also caused by the rubbing of ill-fitting socks and shoes, as well as pressure points from changes in bone structure. Several things can be done to prevent ulcers as outlined in the "Keep Your Feet Fit For Life" checklist. It is essential to incorporate a thorough foot inspection into your daily routine. Don’t forget to look between and beneath your toes! If you have trouble seeing them, do not hesitate to use a mirror to assist you (http://focusonyourfeet.com/products_check.php , http://www.lifesolutionsplus.com/telescoping-self-examination-mirror-p-400.html).
It’s very important to keep ulcers in check. When left untreated, the surrounding subcutaneous tissue can become infected. If the infection is not contained it can spread to the bone. Once the bone becomes infected, the risk of amputating the portion of the toe or foot infected significantly increases.
In addition to following the tips in the "Keep Your Feet Fit For Life" checklist, if you’re diabetic it’s important to visit your podiatrist regularly for a thorough foot inspection. We’ll trim any calluses that build up on the soles of your feet since ulcers can sometimes be sneaky and develop beneath them. Whatever you do, do not trim calluses yourself with a blade or pick at anything you suspect might be a pre-ulcerative wound. You may accidentally introduce bacteria to the site, and this either accelerates progression to an ulcer or makes the pre-existing ulcer take longer to heal.
Showing posts with label ulcers. Show all posts
Showing posts with label ulcers. Show all posts
Monday, November 16, 2009
Monday, November 2, 2009
What You Eat Affects Your Feet!
Has someone ever said to you – "watch your sugar intake, it may hurt your feet someday?" You may have some recollections from childhood of your mother or father limiting your candy intake, especially around Halloween, because the sugar is bad for your teeth. Most of us grew up associating high sugar intake with cavities. November is diabetes awareness month, and we are going to kick it off with a brief overview of what diabetes is and how it affects your feet.
There are two types of diabetes, and type 2 is the most prevalent form of the disease. Type 1 diabetes is caused by an inability of the body to produce insulin, and with type 2 diabetes the body either does not produce enough insulin, or the cell receptors start to ignore the insulin over time. So why is too much sugar such a bad thing? In people without diabetes, the cells in the pancreas secrete insulin that carries the sugar from foods to cells throughout the body. The sugar is then utilized to provide energy for the cells. In people with diabetes, the lack of sugar getting into the cells will weaken the immune system, and the excess sugar in the blood affects the skin, ligaments, joints, nerves, and arteries through a process know as glycation (non-enzymatic gylcosylation). Essentially, the sugar in the blood attaches to proteins and lipids passing by, forming a complex molecule that disrupts normal metabolic pathways eventually hardening nerves and vessels. The glycation process leads to problems in the heart, kidneys, nerves, eyes, and feet.
Some of the first signs of type 2 diabetes are seen in the feet. Loss of sensation in any part of your feet combined with tingling sensations can be one of the earliest signs. While many other things can cause those symptoms, if you don’t already go to your primary care provider for a physical annually, it’s a good idea to start. You primary care provider can order a fasting plasma glucose test with your blood work. Fasting plasma glucose levels of below 100 mg/dl are normal, 100-125 mg/dl indicates pre-diabetes, and 126 mg/dl indicates diabetes as per the American Diabetes Association guidelines (http://www.diabetesarchive.net/pre-diabetes/faq.jsp). Yellowing, thickened toenails with persistent toenail fungus and excessive calluses caused by low-impact activity are also warning signs that should be checked out by your podiatrist. Ulcerations of the tissue beneath the calluses may be present, and if treated improperly they can easily become infected. Therefore, once diagnosed with diabetes it is essential that you follow-up with your podiatrist every few months for foot care.
There are two types of diabetes, and type 2 is the most prevalent form of the disease. Type 1 diabetes is caused by an inability of the body to produce insulin, and with type 2 diabetes the body either does not produce enough insulin, or the cell receptors start to ignore the insulin over time. So why is too much sugar such a bad thing? In people without diabetes, the cells in the pancreas secrete insulin that carries the sugar from foods to cells throughout the body. The sugar is then utilized to provide energy for the cells. In people with diabetes, the lack of sugar getting into the cells will weaken the immune system, and the excess sugar in the blood affects the skin, ligaments, joints, nerves, and arteries through a process know as glycation (non-enzymatic gylcosylation). Essentially, the sugar in the blood attaches to proteins and lipids passing by, forming a complex molecule that disrupts normal metabolic pathways eventually hardening nerves and vessels. The glycation process leads to problems in the heart, kidneys, nerves, eyes, and feet.
Some of the first signs of type 2 diabetes are seen in the feet. Loss of sensation in any part of your feet combined with tingling sensations can be one of the earliest signs. While many other things can cause those symptoms, if you don’t already go to your primary care provider for a physical annually, it’s a good idea to start. You primary care provider can order a fasting plasma glucose test with your blood work. Fasting plasma glucose levels of below 100 mg/dl are normal, 100-125 mg/dl indicates pre-diabetes, and 126 mg/dl indicates diabetes as per the American Diabetes Association guidelines (http://www.diabetesarchive.net/pre-diabetes/faq.jsp). Yellowing, thickened toenails with persistent toenail fungus and excessive calluses caused by low-impact activity are also warning signs that should be checked out by your podiatrist. Ulcerations of the tissue beneath the calluses may be present, and if treated improperly they can easily become infected. Therefore, once diagnosed with diabetes it is essential that you follow-up with your podiatrist every few months for foot care.
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