A diabetic patient’s foot is sensitive and vulnerable to many changes, some of which can lead to severe complications. The umbrella term for these changes in foot health is “Diabetic Foot.” Diabetic foot may include many ailments ranging from infections and ulcerations to severe and irreversible nerve damage. And that’s why diabetes sufferers need to protect their feet with proper orthotics. This post will take a deeper look at diabetic foot and how orthotic support can help patients reduce their risk of developing severe foot troubles.
A Look at Diabetic Foot
The effects of diabetes are widespread - saying this is an understatement. The foot is one of the most susceptible bodily regions to the ravages of diabetes, so much so that doctors warn about foot troubles that may come with uncontrolled blood sugar. But just what disorders fall under the diabetic foot umbrella?
The Diabetic Foot Cluster of Ailments
- Diabetic Neuropathy - High blood sugar damages nerves, especially when it’s uncontrolled, and that can lead to uncomfortable sensations in the legs and feet. This is diabetic neuropathy. Sensations may include pain, “pins and needles”, tingling and the inverse as well - a lack of sensation. The latter is dangerous because if you get a cut and don’t feel anything, it can get infected and spread.
- Peripheral Vascular Disease - Diabetes also affects blood flow by reducing itsit’s reach to the tissues of the foot. The result of this is slow wound healing since cuts and sores need sufficient blood flow to heal fast. In severe cases, the lack of sufficient blood flow can make diabetics with sores susceptible to gangrene, tissue death that comes from a lack of blood.
- Diabetic Ulcers - Ulcers in diabetes patients are worse than typical sores. They are deep sores or breaks in the skin that often start as minor cuts or scrapes but heal too slowly. Even poorly-fitting shoes can produce diabetic ulcers. Diabetic ulcers can become infected if they’re not treated quickly.
Diabetics can also succumb to other foot troubles that affect the general population including Athlete’s foot, dry skin, blisters, bunions are much more. The difference here, however, is that diabetics may suffer from more severe bouts of these conditions and secondary complications as well.
Remember, diabetes impairs wound healing and high blood sugar can compromise one’s immune system, making minor infections more serious. Diabetic foot problems can even go unnoticed because it may creep up on a sufferer unsuspectedly.
Signs Diabetic Foot Has Begun
- Changes in skin colour or temperature
- Swelling in the foot or ankle
- Pain in the legs
- Open sores on the feet that heal or drain slowly
- Foot odour that doesn’t go away
- Ingrown toenails or toenails infected with fungus
- Corns and calluses
- Dry cracks in the skin (especially around the heel)
It’s crucial to see your doctor asap if you notice any of these signs, a combination of them and/or if they persist.
Consequences of Untreated Diabetic Foot
Like most complications of diabetes, a case of untreated diabetic foot may worsen. This isn’t bound to happen, but it is a very real possibility for some patients. Unfortunately, the complications of diabetic foot can be unrelenting and severe enough to cause permanent damage. That’s why it’s vital to treat diabetic foot as soon as you recognize it.
The Possible Complications of Diabetic Foot
- Skin and bone infections - In a diabetes patient, a small cut or wound can get infected. These infections can spread to surrounding regions of skin or worse, into the bones. This requires antibiotic treatment.
- Abscess - If an infection eats into bone or tissue, it will form an abscess, which is a pocket of pus. The abscess requires draining and in severe cases, removal of the bone. However, oxygen therapy is now used instead of bone removal.
- Gangrene - A frightening consequence of diabetic foot is gangrene, tissue death that results from poor blood flow. Patients need immediate treatment with oxygen therapy or surgical removal to prevent further infection, amputation or death.
- Deformities - Nerve damage, which is common in diabetes, can weaken foot muscles and lead to issues such as hammer toes and even high arches.
- Charcot Foot - Due to increased fracture risks and loss of sensation due to nerve damage, diabetics may experience changes in their foot bone. They may walk on broken bones and not realize it, leading to a deformity known as Charcot foot.
- Amputation - Unresolved infections and tissue death (gangrene) that fails to heal and spreads may require amputation. It’s the most effective treatment when all other measures have failed.
It goes without saying that the consequences of unresolved diabetic foot aren’t a cakewalk to manage. They can be painful, frightening and tragic. Fortunately, when managed with the right treatment and lifestyle modifications, these complications rarely occur. Diabetic orthotics play a crucial role in preventing and reducing the damage high blood sugar inflicts on your feet.
How Diabetic Orthotics Can Save the Foot
Diabetic orthotics essentially work like other types of orthotic solutions, albeit with slight differences to keep diabetics’ feet healthy. The main focus of diabetic orthotics and diabetic footwear is to redistribute pressure along the soles of your feet. This helps to relieve high pressure, friction and shear - all of which can lead to and promote the problems mentioned above. These orthotics are generally soft and full-length (both length and width) to support the entire foot and protect all areas of the foot from injury.
The best diabetic footwear, a.k.a diabetic shoes should help offload (remove pressure) from the bottom front of the foot, where ulcers often develop. It should also help promote healthy circulation, prevent skin breakdown and prevent the formation of calluses. This supports the wise saying: “prevention is better than cure”.
Wearing diabetic footwear can prevent the signs of diabetic foot from occuring in the first place. Additionally, diabetic footwear will promote better motion control so that the foot moves better, and thus, has a lower chance of getting injured.
Diabetic footwear in general should also adhere to certain shapes and structures to help keep the feet safe and healthy.
- Toe boxes should be long, deep and broad enough to provide enough room for the toes. A bigger, broader toe box ensures that there is no excess pressure on the toes.
- Diabetic footwear should come with adjustable lace, straps or velcro. This allows patients to fasten the shoe appropriately to hold the foot firmly.
- Shoe linings should be less than 5cm high to reduce pressure on the metatarsal bones (which are at risk of injury and ulceration)
- The inner lining of diabetic footwear should be smooth
Of course, not everyone with diabetes will have the same symptoms and concerns, so ultimately, your podiatrist will have to make recommendations tailored to the individual. Nevertheless, these requirements tend to apply to the majority of patients.
Here at Orthotics Direct, we sell a variety of diabetic orthotics and footwear that adhere to these requirements.
General Reminders on Diabetes and Foot Care
Living with diabetes can be a challenge but with a little effort, it doesn’t have to hold you back. A key “ingredient” for healthy feet in diabetes is observation. Make it a habit to check the quality of your footwear. If at any time you feel pressure, discomfort or a lack of space, see your podiatrist or replace your shoes.
Also, check your feet daily to see if there are any changes in their appearance, colour or texture. Even mild signs such as redness, blisters or cracking skin could be an early warning sign of diabetic foot, meaning you need to address it sooner than later.
Doing these checks will help you stay on top of foot symptoms and help you determine if you need diabetic orthotics. And don’t forget the basics of diabetic care: check your blood sugar levels, eat healthy, get plenty of exercise and take medications prescribed by your doctor. Putting in the effort now can spare you from the consequences of diabetic foot and other effects in the long run.
Need orthotics for diabetic foot care? Get in touch with us to find the right footwear and orthotic solutions.