McKesson Clinical Reference Systems: Women's Health Advisor 2002.2
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What are diabetic foot complications?

Foot ulcers (sores) and infections are a problem that can be caused by diabetes. The severity of the problem can range from minor sores to serious damage of tissues in the foot.

How do they occur?

When you have diabetes, the circulation of blood to your feet is not as good as it should be. It is harder for the body to fight infections and heal itself. As a result, any infections and sores on your feet can become serious. Without treatment, severe infections can cause the flesh of your foot to die (gangrene). Diabetics are 20 times more likely to have gangrene in the foot than people who do not have diabetes.

Because diabetes damages nerve endings, you may not feel pain if you hurt your foot or get an infection. This can make it difficult for you to know that you need medical treatment.

What are the symptoms?

The initial symptoms are swelling, redness, or pain. Sores may appear on the sole of your foot. They may heal but later return in the same place. If the sores are not treated, that part of the flesh of your foot may die and turn black.

How are they treated?

You may need antibiotics or other medications to put on the sore or infected part of your foot. The medicine will help fight infection, rid the wound of dead flesh, and help new, healthy flesh to grow.

You may have to stay off your feet for a while to prevent further irritation of the sores or infections.

You may be hospitalized for treatment. If antibiotics don't heal the infected or ulcerated area, the doctor may have to remove the infected flesh surgically. If you have gangrene, the doctor may have to amputate part or all of your foot.

How long will the effects last?

As long as you have diabetes, you will be at risk for foot infections.

How can I help prevent diabetic foot complications?

Check your feet every day and follow the foot care guidelines given below.

Look at your feet with a mirror at the end of each day to make sure you have no reddened areas, cuts, or scrapes that could become infected.

Bathing and drying:

• Wash your feet every day with soap and warm (not hot) water. Then dry your feet carefully, especially between the toes. Apply lanolin after your feet are dry to keep the skin soft and free of scales.
• If your feet sweat a lot, keep them dry by dusting them with talcum powder.

Treating corns and calluses:

• Don't treat corns or calluses yourself. Do not use over-the-counter products for these problems unless your health care provider says it is OK.
• Tell your health care provider right away if you develop a corn or callus.

Toenail care:

• Cut your toenails carefully. Cut them straight across. Do not cut the sides or the cuticles.
• Clean your nails carefully.
• If your nails are hard to trim, ask your health care provider's office for help.

Foot warmth:

• Wear cotton socks to bed if you need extra warmth for your feet.
• Avoid using hot water bottles or electric heaters to warm your feet. Because you may not fully sense hot and cold with your feet, you may burn your feet accidentally and develop an infection.
• Avoid putting your feet where they could accidentally be burned; for example, on hot sand at the beach, in hot bath water or whirlpools, or near a fireplace.

Footwear:

• Wear soft leather shoes that fit properly.
• Ask your health care provider about specially made shoes, especially if you have foot problems.
• Avoid wearing new shoes for more than an hour a day until they are thoroughly broken in.
• Avoid sitting with your legs crossed.
• Wear clean socks and change them at least once a day.

In addition to these foot care guidelines, good control of your blood sugar and your blood pressure help prevent foot problems.

You may want to ask for more information from:

• American Diabetes Association, Inc.
  1701 North Beauregard Street
  Alexandria, VA 22311
  Phone: 800-DIABETES, or 1-800-342-2383
  Web site: http://www.diabetes.org
• American Podiatry Association
  9312 Old Georgetown Road
  Bethesda, MD 20814-1698
  Phone: 800-FOO-TCARE, or 800-366-8227
  Web site: http://www.apma.org

This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.