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.
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. A large number of amputations could be avoided by consistent use of these appliances.
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.
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.
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. I've prepared 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 treat it alone – visit a nurse at a 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 resuly in the loss of the foot and endanger life!
To your health,
Daniel A. Weisz - Podiatrist