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Learn About Your Risks

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To learn more about your foot health risks, click on the subject to reveal the answer, click the subject again to hide the answer.

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q1-1

People with diabetes have a higher incidence of thickened, deformed, and discolored toenails. These nails are usually affected with a mold, yeast, or fungus infection. Some patients have nails that are black in color and that is caused by a bacterial contamination of the nail. Other patients have thick nails that appear to have a fungus infection but have been damaged by trauma and are not infected. Thick or deformed nails are dangerous for patients with diabetes. The pressure from the shoe against a thick nail can cause a soft tissue abscess and infection under the nail that can lead to a bone infection and amputation. A deformed and long toenail can cut the skin of the toe next to it and cause a soft tissue infection, ulcer or bone infection and lead to amputation. Most people fail to realize that a toenail that has a mold, yeast, or fungus infection is an infection that can be contagious and may be transferred to other people. If you have thickened, deformed, and discolored toenails see your foot care specialist for proper diagnosis and treatment.[/vc_toggle][vc_toggle title=”The sides of my toenails dig into the skin and hurt.” el_id=”1479068913764-8fe3080a-f185″] 

ingrowntoenail

Ingrown toenails happen when a piece of the nail grows into the skin. This often times painful problem is very common and is not directly related to diabetes. However, it is a more serious health problem for people with diabetes as it carries higher risks for soft tissue infection, ulceration, bone infection, and amputation. Patients may be born with nail borders that are curved and tend to chronically grow into the skin. Other reasons for ingrown toenails are the result of faulty nail trimming; either failing to trim the nail totally across the end, thus leaving a portion of the nail at the edge that can grow into the skin or trimming the nail too far back on the sides causing a piece of nail to grow into the skin. In some cases a patient may have experienced direct blunt trauma to the nail, such as dropping a heavy object on the nail or someone stepping on the nail. The results of this trauma can cause damage to the nail and a bone spur to develop under the nail that deforms the nail. The nail then becomes centrally elevated and the nail borders become severely curved and ingrown. Luckily there are solutions to the problem that are safe and effective that can be used for patients with diabetes. If you have ingrown toenails, see your foot care specialist for proper diagnosis and treatment.[/vc_toggle][vc_toggle title=”I have a large boney prominence or bump behind my big toe on the inside of my foot.” el_id=”1479069225424-691339d4-27e4″]

q3

People with diabetes that have bone deformities such as a bump behind the big toe that is called Hallux Abducto Valgus or a Bunion have a higher risk for soft tissue infection, ulcers, bone infection and amputation due to formation of pressure points against the bone from their shoes. See your Pedorthist for an evaluation for shoe modifications, special shoes, insoles, and orthotics, or your foot care specialist for preventive foot care or surgery to correct the deformity.[/vc_toggle][vc_toggle title=”I have a large boney prominence or bump behind my small toe on the outside of my foot.” el_id=”1479069484088-462ad734-a090″]

q4

People with diabetes that have bone deformities such as a bump behind the small toe that is called a Tailor’s Bunion have higher risk for soft tissue infection, ulcers, bone infection and amputation due to formation of pressure points against the bone from their shoes. See your Pedorthist for shoe modifications, special shoes, insoles, and orthotics, or your foot care specialist for preventive foot care or surgery to correct the deformity.[/vc_toggle][vc_toggle title=”I get an extremely sharp or burning pain to the area of the front of my foot that can go into the toes of back up my foot.” el_id=”1479069625711-13960092-59d4″]

q51-e1374166080303

People with diabetes are subject to various neurological problems caused by chronically elevated blood sugars. One very difficult problem to properly diagnose and manage is foot pain. Most people with diabetes who have foot pain are diagnosed with diabetic sensory neuropathy and while a significant number of patients do have that problem, other sources of foot pain to be investigated as many patients have multiple or overlapping reasons for foot pain. These include a pinched nerve between the metatarsal bones, behind the ankle or in the back.[/vc_toggle][vc_toggle title=”My toes are not straight; they are cocked up, bent and hurt.” el_id=”1479069743973-b330f7f2-28e9″]

q6

People with diabetes that have bone deformities such as toes that are not straight, cocked up or bent called hammer toes, mallet toes or claw toes, have higher risk for corns, soft tissue infection, ulcers, bone infections and amputation due to formation of pressure points against the bone deformity of the toes from their shoes. See your Pedorthist for shoe modifications, special shoes, insoles, and orthotics, or your foot care specialist for preventive foot care or surgery to correct the deformity.[/vc_toggle][vc_toggle title=”I have callouses on the ball of my foot that may or may not be painful that keeps building up.” el_id=”1479069884672-37871ace-174a”]

q7

People with diabetes that have soft tissue deformities such as calluses on the bottom of their foot have higher risk for soft tissue infection, ulcers and amputation due to formation of pressure points against the soft tissue lesions from their shoes. See your Pedorthist for shoe modifications, special shoes, insoles, and orthotics, or your foot care specialist for preventive foot care or surgery to correct the deformity.[/vc_toggle][vc_toggle title=”I have corns on the toes that get thick no matter what size shoe I wear.” el_id=”1479070025807-3a4b55f8-c610″]

q10

People with diabetes that have soft tissue deformities such as corns on the top, the tip or between the toes, have higher risk for soft tissue infection, ulcers, bone infections and amputation due to formation of pressure points against the soft tissue lesions from their shoes or other toes. See your Pedorthist for shoe modifications, special shoes, insoles, and orthotics, or your foot care specialist for preventive foot care or surgery to correct the deformity.[/vc_toggle][vc_toggle title=”The inside of my arch and bottom of my heel hurts and its most affected the first step out of bed in the morning.” el_id=”1479076445998-5145005f-f761″]

img_2251-e1375125469608

Heel and arch pain is another common foot problem that may cause patients with diabetes to change the way they walk. Although it has nothing to do with diabetes, any changes in gait due to pain can cause serious problems for patients with diabetes. The causes of heel pain can vary. They can include plantar fasciitis, heel spur, pinched nerve, fracture, tumor, arthritis, trauma or other faulty foot function. If you are suffering with heel pain be sure to discuss it with your healthcare providers.[/vc_toggle][vc_toggle title=”Sometimes I lose my balance or even have fallen because I cannot feel the floor with my feet.” el_id=”1479076561716-737572b3-3b5a”]

q101

Patients with diabetes often lose their balance. Many patients with diabetes have fallen or have nearly fallen. Most times, they believe they have mis-stepped or forgotten to look where they were walking. But, in fact, they may be suffering from numb feet and cannot feel the floor; the result of chronically elevated blood sugar levels. Some patients fall only occasionally, while others fall more frequently. Generally, patients with diabetes who fall don’t like to tell anyone about it. They are fearful that they will be placed in a more supervised environment, (rehabilitation center, nursing home, adult congregate living facility, or extended care facility), by their children for their own protection. There are several causes for this problem. One may be a problem with the inner ear, which is the location of the body’s balance mechanism. Another may be the medications you take. Nerve damage to your feet and legs due to chronically elevated blood sugar levels may also cause you to lose your balance. If you have this problem, discuss it with your healthcare providers.[/vc_toggle][vc_toggle title=”I have cramps in my legs that always happen when I walk and pain in my legs at night.” el_id=”1479076856299-4c90d8d9-4981″]

q11

Our circulatory system is composed of the arterial, the venous, and the lymphatic systems. The arterial system brings fresh oxygenated blood to our organs and extremities; the venous system returns the blood back to the heart; and the lymphatic system acts as the sewer pipes of the body to remove debris. While vascular disease is a separately diagnosable problem from diabetes, chronically elevated blood sugar levels contribute to arterial disease in the patient with diabetes. The symptoms associated with lack of circulation may include leg cramps when walking which is called “intermittent claudication” or pain in the legs at night while lying in bed due to lack of arterial circulation which is called “rest pain.” If you have problems with your circulation, be sure to discuss them with your healthcare providers.[/vc_toggle][vc_toggle title=”The skin of my feet is always dry and scaly—sometimes they itch, too” el_id=”1479153827160-7b597a63-a473″]

dryscalyskin

People with diabetes can have soft tissue deformities such as dry scaly skin and peeling or cracking of the skin of their foot. Dry scaling skin is associated with autonomic neuropathy where the nerves that innervate the oil glands in the skin do not function properly. This leaves the skin dry and itchy. A problem with the venous circulation can also make the skin dry and itchy, but scratching this itch can result in a venous leg ulcer. Cracking of the skin between the toes may be the result of a bacterial, fungal or mixed bacterial and fungal infection. This infection can be contagious and should be treated promptly. Fissures or cracking of the skin may occur at a skin crease on the bottom of the toes or on the heels. These breaks in the skin are caused by a neurological malfunction caused by chronically elevated blood sugars and may lead to infection and place the patient with diabetes at higher risk for ulcers, soft tissue infections, bone infections and amputation. See your foot care specialist for proper diagnosis and treatment.[/vc_toggle][vc_toggle title=”I have burning, tingling or numbness in my feet.” el_id=”1479153976159-d2206f23-ee34″]

burning

Burning, tingling, or numbness to the feet are symptoms usually associated with neurological problems. In some cases, these symptoms may be caused by problems in the low back, such as a bulging disc or bone spur pressing against a nerve or, by a pinched nerve behind the ankle or in the front of the foot between the toes. Other possible reasons for these symptoms may include; tumors, chemotherapy for cancer, and exposure to radiation, pesticides or, heavy metals, such as lead or mercury. Chronically elevated blood sugar levels in the patient with diabetes can also affect the nervous system and produce these same symptoms. If you have this problem, discuss it with your healthcare providers.[/vc_toggle][vc_toggle title=”I have an open wound on my foot or leg.” el_id=”1479154112711-a2d5bf36-5938″]

footulcer

An opening on the skin of your foot is called an ulcer. Ulcers develop due to silent or painless trauma to the foot from mechanical, chemical, or thermal trauma. If a patient fails to visually inspect or touch their feet every day they may not know they have an ulcer until they see blood or pus on their socks. Ulcers may be located on any area of the foot. Common locations are on the toes, between the toes, at the tips of the toes, or on the bottom of the foot. Hospitalized or bedridden patients may also develop ulcers on their heels or ankles. When patients with diabetes have ulcers healing can take an unusually long time due to problems with circulation and the immune system. Ulcers are often the initial injury that can ultimately trigger a lower extremity amputation. If you have a hole in your foot, see your healthcare provider right away![/vc_toggle][vc_toggle title=”Do I need diabetic shoes?” el_id=”1479154247886-f5e8aca4-bac5″]

diabeticshoes

Diabetic shoes are meant to cover, support and protect the foot. Typically, diabetic shoes are wider and deeper in the toe box to accommodate deformed feet. Not all patients with diabetes need diabetic shoes. Patients who have a foot deformity and a combination of either poor circulation or numb feet should use diabetic shoes. To find out if your feet and foot health can benefit from wearing diabetic shoes, you should have a monofilament test.[/vc_toggle][vc_toggle title=”I can not reach my feet?” el_id=”1479154384449-c2655ffd-6f0c”]

bottomoffoot

If you can not reach your feet, you may have difficulty keeping your feet clean, treating skin infections, or dry skin. Clean feet are an important part of an overall foot health and disease prevention plan. Patients with diabetes need to wash their feet with soap, rinse well, and dry well, especially between the toes. Dry skin on the feet and legs may be caused by a malfunction of the nerves to the sweat or oil glands that results in itching or cracking of the skin and infections. Lotions containing a chemical name UREA are the best at bringing moisture from deep within the skin to the skin surface.[/vc_toggle][vc_toggle title=”I can not see my feet?” el_id=”1479154524699-7d924408-bba2″]

foothealthy

A critical part of your preventive foot health program is to visually inspect your feet daily. If you cannot see your feet, use a mirror or have a family member or friend look at your feet for you every day. Patients with diabetes need to examine their feet for cracks in the skin or any area that is red, warm, swollen, or tender to the touch. If you have any of these symptoms, see your foot specialist right away.[/vc_toggle][vc_toggle title=”I have had a previous amputation.” el_id=”1479154666748-efb97894-ad4f”]

amputationinfo

Every year in the United States, patients with diabetes have more than 90,000 lower extremity amputation procedures. Worldwide, there are more than 1 million lower extremity amputation procedures due to the effects of diabetes; one every 30 seconds. Patients who have already had an amputation are the most likely to have a second amputation. Research studies have shown that thirty eight percent of patients with diabetes who undergo a lower extremity amputation will lose the other leg within 5 years. Even worse, forty seven percent of those patients with diabetes who lose a leg will not survive 5 years. Additional research has shown that the prognosis for the patient with a foot ulcer or lower extremity amputation is worse than all forms of cancers combined, except for pancreatic and lung cancers. If you have had any part of your foot or leg amputated it is very important that you have a professional evaluation of your feet and legs by your foot care specialist to prevent another amputation at least once a year for an annual preventive foot exam and more frequently for ongoing foot care for corns, nails, and calluses.[/vc_toggle][vc_toggle title=”I have persistent pain.” el_id=”1479154818386-355f598e-28c2″]

pain

Foot pain in any form is not normal. he problem that patients with diabetes face is to figure out the cause their foot pain. Is the pain just in the front part of the foot just behind the toes or is the entire bottom of the foot hurt? What is the nature of the pain? Dull, throbbing, achy, or sharp, burning, tingling, or numb? Let’s focus on nerve pain, as this is a common problem for people with diabetes. All too often the complaint of foot pain by a patient with diabetes almost always is diagnosed as diabetic sensory neuropathy and sometimes the patient’s foot is not even examined. Other than diabetes, the likely causes of foot pain that is usually mistaken for neuropathy is a pinched nerve just behind and between the toes called a neuroma or neuritis in the forefoot, a pinched nerve behind the ankle, or pain in the foot that is referred from the back called radiculopathy. Pinched nerves in the foot can produce terrible burning and shooting pain. Luckily, they can easily be treated. If conservative care fails to alleviate the pain, then surgery is a legitimate alternative, even for patients with diabetes, to remove the affected portion of the nerve and relieve the pain. If you have this problem, discuss it with your healthcare providers.[/vc_toggle][vc_toggle title=”Do I need to have a monofilament test every 12 months?” el_id=”1479154984721-fe83e543-54c4″]

monofilamenttest

The Monofilament Test is the gold standard used worldwide to diagnose diabetic patients for Loss of Protective Sensation for Pain (LOPS) on the bottom of their foot is the Monofilament Test. LOPS causes the patient with diabetes to lose their ability to sense trauma or pain to their foot. Without protective sensation patients with diabetes are vulnerable to silent or painless trauma of mechanical, chemical, or thermal origin. Painless or silent trauma often is the triggering event that can lead to soft tissue infection, ulcer, bone infection, and amputation.[/vc_toggle][/vc_column][vc_column width=”1/3″][vc_widget_sidebar sidebar_id=”td-default”][/vc_column][/vc_row]