The 7 Very Simple Ways You Can Lose Your Diabetic Feet Or Toes

diabetic feet

Diabetes is a big problem. Around 415 million people have it in the world (American Diabetes Association)

If it was a country it would be the 3rd largest in the world (International Diabetes Federation)- and Diabetes is increasing in every single nation.

diabetic feet world

Great picture borrowed with love from https://en.wikipedia.org/wiki/File:Winkel_triple_projection_SW.jpg

Just in the US, every day 5000 people get diagnosed (American Diabetes Association).

So what seems to be the problem? What is the big concern with Diabetes?

It is the complications- what living with Diabetes can cause. So wherever blood touches it can affect. So your eyes, kidneys all the way down to your feet.

"People with diabetes are far more likely to have a foot or leg amputated than other people"- American Diabetes Association.

Most people think about feet and toes being removed. BUT…before that can happen we need your skin to break down or to become injured.

So what is an ulcer, or skin breakdown?

diabetic foot ulcer

An ulcer is the opening of the skin due to trauma, circulation or nerve issues that doesn’t really want to heal.

The skin is an amazing organ as long as it is kept in good shape and not allowed to be damaged or for its to loose its ability to keep you safe

9 ways diabetic feet

Diabetic ulcers are an issue because:

  • patients tend not to initially feel them and this allows the ulcer to grow (wider and deeper rather than the ulcer actually “growing”) and become complicated
  • if you had no issues then a cut is usually sore and the body has a really good way of treating them. However a diabetic usually has complications that tend to reduce healing
  • diabetics have a normal reduced immunity
  • in some cases the circulation is poor to allow adequate healing/getting antibiotics to the area
  • any ulcer can be quick to heal or take a really long time (years with some leg ulcers)
  • even when the ulcer is healed it will take 2 years to heal the underlying structures. If the ulceration starts again within 6 weeks then it is the original ulceration that wasn’t healed.
  • the foot is a complicated place to have an ulcer because you need your feet to walk- so any dressing under the foot tends to get squished out. Components of the foot like bone, tendon, muscle and ligaments tend to be in close proximity to one another and there is very little “padding” in the way of large muscle or fat. So any ulcerations complicate quickly and affect neighbouring structures.
  • foot ulcers especially can go from healing to bad in a very short space of time
  • bad blood sugar control reduces healing.

Among patients greater than 20 years old, Diabetic Foot Ulcerations account for two-thirds of all non-traumatic amputations. (American Diabetes Association)

Then if you think after an amputation everything is going to be OK…well.

After an amputation, the chance of another amputation within 3 to 5 years is as high as 50 percent (California Podiatric Medical Association)

Then we have the cost of treatment.

The cost of diabetic foot ulcers is greater than that of the five most costly forms of cancer (Diabeticfootonline.com)

Then we have the elephant in the room. What does the rest of life look like?

Diabetic foot ulcer patients have a low survival prognosis, with a 3-year cumulative mortality rate of 28% (diabetesjournals.org)

Seems quite depressing right? Because of that, here is a bear in bunny slippers just to cheer you up :) (No idea where the picture is from, but its great)

diabetic amputation

Here's a short Youtube video to share to someone you know who has Diabetes. Make them aware.

The Uninformed patient

Unfortunately many patients will try and fix an issue with their feet before coming to see the Doctor. Sometimes they will search “Dr Google”, find over the counter medications and other times they consult with friends/ relatives before coming to see the clinician.

These are the most common things patients have done to their feet:

  • apply corn plasters or hard skin removers which make the matter worse (there is a warning label on those devices). Those can injure good as well as "bad" tissue in the areas. Also if you can not feel it, then they keep on working and traveling and they can form a bigger problem than just the corn/ hard skin you originally had.
  • treat the callus by peeling it or hacking at it with any implement that we find, apart from not being clean, those 2 ways always causes the skin to bleed- which leads to infection. Usually each week someone has come into the clinic because they pulled their hard skin
  • leave the issue alone…it will go away. No it wont. Cycles build up where the body tries to protect itself and in turn causes more issues. The original problem needs to be fixed. So in the below picture we have pressure, which forms hard skin, which adds more pressure to the area, which allows more hard skin to be put down. Eventually underneath that hard skin will break down due to the amount of pressure being placed upon the soft tissues.
  • just because you can’t feel it doesn’t mean that it is healing. We had a patient with an oozing purple toe and they thought it was fine because they couldn’t feel it. Diabetes can affect your feeling- light touch initially and then heavy touch later on.
  • apply chemicals to ulcerations believing that they are helpful. Apart from the weird, many patients apply Hydrogen Peroxide to wounds. The “fizz” they believe, is working. No, it actually wipes out the good chemicals and makes the wound more complicated. You make the wound worse.
  • leaving cuts/ wounds/ diabetic foot ulcers to the open air is one of the most wrong things that you can do. The air is full of bugs and also our own personal collection of bugs can jump into the wound if it is not clean and covered. Clean the area with saline solution and dress with a dry dressing, then go to see a Doctor/ Podiatrist.
  • use shoes which dont fit, rub or cause trauma by having objects inside them (like toys and grit). We found a toy car in one shoe. Shoes also have a shelf life. So some running shoes with start to "drop off" in the effectiveness at around 500k. So worn out shoes can be an issue:
diabetic feet

Diabetic foot ulcers can be very quick to go from good to bad. They can become infected quickly and if left can cause many issues that the health care team can not rectify.

Diabetes by itself can be bad…but you can also have combination problems.

diabetes smoking

One bad one is Diabetes and smoking

Diabetes and smoking is not one of the best combinations out there. Lets just go with that from the start.

Lets also smash a couple of smoking myths.

  • Smoking does not keep you warm on a cold day. Actual it works in reverse. The chemicals that it releases, like Carbon Monoxide, kick off the oxygen in your blood and sit there instead. This now reduces the amount of nutrient Oxygen that your cells have. On top of that the Nicotine constricts your blood vessels. In this case even more blood is restricted to the tissues and your extremities- fingers and toes, feel more cold.
  • Diabetes increases the deposits of Cholesterol into your blood vessels which narrows them. Add smoking then those vessels become even more restricted.
  • Smoking reduces nutrients to an area and if you have Diabetes your body needs all the nutrients that it can get. If you have an ulcer/ open wound then it is going to take even longer to heal and because of your bodys healing capabilities have now been diminished bacteria and microorganisms can get in an overpower the system quite easily.
  • Especially in heavy smokers, they spend more on their smoking habit than they do on their nutrition. So you have a particularly heavy smoker whos body is not getting the appropriate nutrients then starts to have a poor diet.
  • Smoking affects Insulin- smoking also associated with Insulin resistance.
diabetic footcare complications

As fat is placed in your blood system the amount of blood going through is the same but it increases in pressure as there is a smaller area to get through. Layers of fat build up and a trickle of blood now gets through. With smoking it rapidly increases this system reducing much needed nutrients to your cells. When you add Diabetes and smoking then it just goes into overdrive. So the risks increase drastically.

Then you have increased risks

With just diabetes you have risks which are increased as you go down the body. So you are twice as likely to get a stroke, 4 times as likely to get a heart issue and 7 times more likely to get a foot problem. When you add in diabetes and smoking, you can double those rates, sometimes even triple them. So you are 14 or 21 times more likely to get a foot issue if you smoke and are Diabetic.

Diabetes and smoking is not the best combination…at all. If a patient can start to cut down on your smoking habit, then you can quit. It will be the best decision the patient has made.

How You Can Protect Your Diabetic Feet? There is a great deal of light at the end of the tunnel

You have probably heard so much about the problems that Diabetes can cause to Diabetic feet. “Amputations”, “my feet will fall off”, “I will never be able to wear any shoe again”- these are just some of the real comments made by my patients.

Diabetes has got the whole world in a strangle hold. You don’t know if to keep your feet off the ground all day, everyday or even dare to walk on the floor.

Healthcare professionals are getting on board now that the best treatment for diabetic foot ulcers is to treat the cause as well as treating the ulcer. It can be hard and long but now it is a joint process with you and the healthcare team working together.

diabetic feet overtime

According to HealthSystemTracker “since 1990 the risk of complications have reduced depending upon the complication”. Why? Well they found out that “preventive health care and controlling risk factors are among the reasons for a decline in diabetes complications.”

When you start really looking into Diabetes complications, you see a ray of light, you see that it doesn’t have to be all bad.

The American Academy of Family Physicians found something similar. Rates of people being diagnosed with Diabetes are increasing…BUT…there is a drop in complications…because: “Researchers pointed to possible reasons for the drop in diabetes-related complications, including “…patient education in disease management and clinical decision-making"

 "The risk of foot ulceration and limb amputation in people with diabetes is lessened by patient education” (Emedicine)

Up until recently there has only been 12 identifiers of how to protect your diabetic feet- to try and prevent amputations and ulcerations.

However I have actually found 25 different ways to prevent issues from occurring to your diabetic feet.

These range from:

  • Nerve testing
  • Circulation testing
  • Nail, hard skin and corn care
  • All the way to questions that you should be asking your healthcare provider to get the optimum results for you about how to care for your diabetic feet.

Diabetes doesn’t have to scare you…you just need to be empowered to deal with whatever it throws at you, knowing you have done your best to protect your diabetic feet.

Click here to see how you can help your diabetic feet.

Download for free this page in PDF and read it off line here: Care For Your Diabetic Feet.

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About Dominic Hough

Hi. I'm Dominic. I treat patients every day at a local clinic. I am a trained Chiropodist and I care about prevention. I designed the website to help readers understand treat and even prevent issues from happening to their feet.