Diabetic foot - causes, symptoms and prevention.

How do you recognise diabetic foot syndrome when it has already occurred? What does it mean for a person with diabetes? Can such complications in diabetes be prevented? Find answers to these and other questions about diabetic foot.

Complications in diabetes

Complications such as diabetic foot in type 1 and 2 diabetes can occur with varying severity. They are usually caused by untreated disease. High blood sugar levels in diabetes promote further health problems. Early-stage diabetes complications include lactic or ketoacidosis.

In improperly treated or completely neglected diabetes, cardiovascular diseases appear. Heart attacks, strokes, coronary heart disease and atherosclerosis are among the most severe complications of diabetes and cause considerable concern. They are responsible for numerous deaths among people with diabetes, and the risk of premature death rises with each year of struggling with the disease.

Elevated blood sugar can also lead to kidney damage, nerve damage and vision loss, frequent infections and worsening dental condition. All these problems encourage a serious approach to diabetes. Regular treatment and health monitoring can limit negative effects of fluctuating blood sugar levels.

What is diabetic foot?

A complication worth closer attention and quick prevention is broadly understood foot problems. So-called diabetic foot is a cause of frequent amputations among people with diabetes, although such pathological changes can be prevented. Unlike many complications of diabetes, this can be quickly noticed by the patient themselves. At this stage there is not yet a threat of losing the lower limb or serious deformities.

Diabetic foot syndrome comprises many tissue injuries in the feet. The most actively used and most distant parts of the body from the torso are affected by many of the problems mentioned earlier. Disorders of proper functioning may involve nerves, joints and bones, blood vessels and, as a result, whole tissues daily exposed to external factors. Foot conditions in diabetes are also linked to pain in various situations and prolonged infections.

Symptoms of diabetic foot

Visible symptoms of this diabetes complication are hard-to-heal wounds, including small ones. Patients may find such wounds only after several days because they are not painful. Scratches and bruises from mechanical damage result from nerve dysfunction in the foot. Impaired pain perception and changes in temperature and deep sensation occur.

Diabetic foot syndrome may also involve various types of pain. A worrying symptom, even without damage on the foot surface, should be prickling, burning, numbness, dull or piercing pain. It often intensifies during rest and at night.

Causes of diabetic foot

Persistent hyperglycaemia in diabetes causes a strong neurohormonal response throughout the body. The stimulated immune system and inflammatory activators cause a series of damage and disorders in tissue repair. Feet are strongly exposed to these negative effects of excess blood sugar — they are the parts of the body farthest from the heart pumping blood and from organs secreting substances regulating body function.

Foot conditions in people with diabetes result from impaired circulatory or nervous systems and progressive destruction of bones and joints in later stages. Nerve defects in the foot lead to more frequent injuries. They remain unnoticed due to lack of pain, and through oversight infections can develop in wounds. Ischaemia causes tissue necrosis. Disturbed immune responses due to glucose metabolism changes with excess glucose and ischaemia promote prolonged inflammatory states. The situation is not improved by frequent contact of feet with bacteria, fungi and various contaminants.

Types of diabetic foot

The multitude of diabetic foot syndrome symptoms results from distinguished variants of this condition. Depending on the degree of damage to blood vessels or nerves, problems of different types predominate. The mixed form occurs in about 15–20% of cases.

Neuropathic diabetic foot

Nerve damage in diabetes, known as peripheral neuropathy, causes muscle weakness. These muscles are responsible for maintaining proper foot shape and movement when walking. Incorrect foot pressure on the ground then causes calluses (thickening of the stratum corneum in areas of strongest pressure) and skin damage. Mentioned pain perception disorders lead to serious mechanical injuries. Bacterial infections, contamination or ulceration occur due to tissue breakdown.

Occurrence of sensory neuropathy, i.e. lack of pain, does not mean complete lack of sensation. Conversely, with this type of diabetes complication neuropathic pain may appear. Sensations intensifying at night include numbness, prickling and other unpleasant touch sensations. A swaying gait, foot deformity and lack of sweating are also characteristic.

Neuropathic diabetic foot is the overall set of changes resulting from nerve damage in the lower limbs described above.

Ischaemic diabetic foot

This type of diabetes complication results from progressive atherosclerosis and circulatory system dysfunction. Tissue hypoxia and malnutrition cause bone and joint diseases: osteoporosis, inflammation of bone and bone marrow. Due to weakening, fractures and dislocations occur more often. Frequent damage leads to significant foot deformity. Ischaemia also causes tissue necrosis.

Foot and leg pain appears, especially during exertion. Ischaemic diabetic foot shows classic ischaemia symptoms: numbness, low temperature, marked pallor when legs are raised and weakly palpable pulse. There are no significant sensory disorders, and visible changes have a necrotic character (black discoloration). These can lead to inflammatory states and secondary infection by pathogens.

Diabetes – risk of diabetic foot complications

Beyond hyperglycaemia in diabetes, coexisting conditions and lifestyle predispose to diabetic foot. For the ischaemic variant these are mainly: atherosclerosis, coronary heart disease, hypercholesterolaemia, previous heart attack or stroke. Presence of microvascular diabetes complications such as nephropathy or retinopathy increases the risk of neuropathic diabetic foot. In both cases smoking increases frequency of occurrence.

Prevention of diabetic foot syndrome in diabetics

If skin on the feet is dry and begins to crack during diabetes, specialist creams and ointments are an easily available solution. Some are even marked as recommended for diabetics. For minor injuries and wounds, cleaning and observation during healing help avoid serious infections. Use of appropriate socks and footwear is recommended. As with healthy people, any fungus and foot changes should be treated promptly. If popular preparations do not work, a doctor visit is necessary.

It is also worth maintaining a proper diet, especially with a tendency to atherosclerosis or elevated cholesterol. This relieves the circulatory system and allows efficient operation.

Above all, prevention of diabetic foot syndrome is regular treatment of diabetes and medical check-ups. Observing one's health, foot condition and other worrying symptoms helps prevent acute forms of the disease and related disorders throughout the body.

Deomed® socks – use in preventing diabetic foot

Diabetics' feet prone to infection, mechanical chafing and blood supply problems require greater attention and protection. Using medical socks and appropriate footwear is an important preventive action or support in fighting the condition. By reducing the risk of skin damage we counter the most distressing symptoms of diabetic foot syndrome.

Specialist medical socks Deomed® are registered as a medical device, which verifies their properties. Although products described as medical or health appear on the market, only legal regulations and related controls can be real quality assurance.

Deomed® medical socks have a range of properties that help avoid many foot problems and ease complaints related to foot conditions:

• They are very elastic and have gentle cuffs that do not cause compression, skin damage and enable free blood and body fluid flow,
• They have no seam or an imperceptible seam over the toes, thinner than the sock itself, preventing chafing and skin cracks (including imperceptible ones),
• They have lasting antibacterial and antifungal action that limits the risk of infection.

Important! Deomed® products are registered as medical devices, which does not mean they treat specific conditions. They may be used in the prevention of various conditions, may help prevent their onset and relieve symptoms associated with those conditions. Articles published on our blog are for informational purposes and draw attention to possible medical issues, but they do not relate to specific health cases and should not be used as medical knowledge or medical advice. All medical matters should be discussed with an appropriate doctor.