Diabetes &

Diabetic Foot Care

Maria M. Buitrago, DPM, MS, FACFAS, FAENS

Diabetes
Diabetes mellitus is a chronic disease that
affects about 29.1 million Americans
(~10% of the population)
It causes your blood sugar levels to be
higher than normal

Diabetes
Diabetes Type 1
Body produces less or no insulin
5-10%
Insulin

Diabetes Type 2
Impairs the bodys ability to convert sugars,
starches, and other foods into energy
90-95%

Diabetes
Diabetes is the 7th leading cause of death
by disease in the United States, 2010
2 out of 3 persons with diabetes die from
complications from heart disease or stroke

Why are feet so important

to those with diabetes?

Nerves
Circulation
Immune System (ability to fight infection)
Kidneys
Eyes

Nerves
Diabetes can damage the nerves in the
feet this is called peripheral neuropathy
Affects about half of all persons with
diabetes
This can lead to a condition called
Charcot Foot

Symptoms of Peripheral
Neuropathy
Numbness, pain, tingling or burning in the
feet
Pain at night
Cramping

Peripheral Neuropathy
The erosion with
callus on the tip of
the toe is typical of
the type of injury
which results with
sensory
neuropathy of
diabetes

Charcot Foot
Diabetic complication
where because of
diabetic motor and
sensory neuropathy,
you can develop
multiple midfoot
fractures. The result
is a misshapen foot
as seen here.

Circulation
Diabetes can also
affect circulation in
the feet
Poor circulation
can affect the
ability of the body
to heal when
damaged

Gangrene
Form of necrosis that
develops due to
insufficient blood supply
Usually the result of
atherosclerosis of the
arteries of the leg

Gangrene

Immune System
Diabetics are also
more prone to
infection the bodys
immune system that
normally fights
infection responds
slower

Cellulitis infection in
the skin.

Kidney Disease
Diabetes is the main cause of kidney
failure in 44% of all new cases (2011)
In 2011, 49,677 people of all ages began
treatment for kidney failure due to
diabetes

Kidney Disease
In 2011, a total of 228,924 people of all
ages with kidney failure due to diabetes
were living on chronic dialysis or with a
kidney transplant

Eye Disease
In 20052008, of adults with diabetes
aged 40 years or older, 4.2 million (28.5%)
people had diabetic retinopathy, damage
to the small blood vessels in the retina
This may result in loss of vision

Amputations
About 86,000 lower limbs are amputated
annually due to complications from
diabetes
About 60% of non-traumatic lower-limb
amputations among people aged 20 years
or older occur in people with diagnosed
diabetes

Amputations
The key to amputation prevention
Early recognition
Regular foot exams, at least annually

Warning Signs
Skin color changes
Elevation in skin temperature
Swelling of the foot or ankle
Pain in the legs

Warning Signs
Open sores on the feet
Ingrown and fungal toenails
Bleeding corns or calluses
Dry cracks in the skin, especially around
the heel

Diabetic Foot Care

Wash your feet daily with lukewarm water
and mild soap
Inspect your feet and toes daily for cuts,
bruises, sores or changes to the toenails
Look after your health (loose weight, stop
smoking, exercise and reduce alcohol
consumption)

Diabetic Foot Care

Cut your toenails straight across, never cut into
corners, use an emery board
Do not try to remove corns or calluses yourself
and NEVER use commercial corn cures they
can burn the skin.
Dont go barefoot

Diabetic Shoe Gear

Be properly measured and fitted for shoes
Poorly fitted shoes are a common cause
of problems in the foot
Have your feet measured every time you
buy new shoes (foot size and shape
change over time)

Diabetic Shoe Gear

New shoes should be comfortable when
purchased and should not need to be
broken in
Shoes should fit both the length and width
of the foot, with plenty of room for the toes

Diabetic Shoe Gear

Avoid shoes with high heels, pointed toes
or tight around the toes (these put too
much pressure on the foot and can
contribute to ulcers)
Dont wear anything that is too tight
around the legs this can constrict
circulation to legs and feet

Diabetic Shoe Gear

Dont wear shoes without socks could
cause friction blisters
Dont wear sandals or other open-toed
shoes they dont protect your feet
Wear well padded white socks when you
take socks off you can see blood

Diabetic Shoe Gear

Shop for new shoes at the end of the day
because your feet swell
Change socks and shoes every day. Have
at least two pair of shoes so you can
switch them every other day

Diabetic Shoe Gear

Look inside your shoes every day for
things like gravel or torn linings. These
things could rub against your feet and
cause blisters or sores

THANK YOU