Having diabetes can complicate your life in many ways. It can even cause problems for your feet. How can this happen?

This disease, accurately named diabetes mellitus, is a chronic disorder that is characterized by high blood glucose levels. High sugar levels in the blood can result in tissue and organ damage. Diabetes mellitus is caused by faulty insulin, no insulin, fewer amount of insulin, or changes in the body’s reaction to this hormone. Insulin breaks down blood glucose so that it can be used by the body for energy.

The pancreas produces insulin, and diabetes mellitus can be subdivided into two principle types. Persons suffering from Type 1 diabetes have defective insulin producing cells, so that the body cannot produce the hormone, or can produce only very low levels of it. On the other hand, people suffering from Type 2 diabetes have resistant body tissues, and will often have a different, more extensive treatment and maintenance regimen. People with diabetes have to eat special diets, avoid certain foods, and take medication that can allow them to maintain good blood insulin levels.

By Anna Ferguson

It happens every year. With the onset of open-toed sandals, mile-high wedges and obligatory barefoot excursions, the warm months of summer aren’t exactly the kindest days to feet.

“In the summer, there are several problems that keep me in business,” said Dr. Courtney Bordenkecher, a podiatrist with Allied Ankle and Foot Care in Lawrenceville. “Sandals expose feet to more elements and people are more active, leading to more injuries. You also see a lot of people walking around barefoot and in flip-flops, which are the most common issues.”

Flip-flop flops With flimsy soles and practically no support, flip-flops “should pretty much just be thrown out,” Bordenkecher said. Strained arches and cracked heels are ubiquitous conditions linked to the thin summer shoe. Wearers have to work to keep the shoes on, clinging to the thong between the toes, which can lead to foot deformities and extra foot stress, Bordenkecher said. “I say, just don’t wear them,” she said.

Foot pain can certainly be caused by any number of reasons. However, foot pain resulting from diabetes is both painful and very common for those living with diabetes.

Diabetes and foot pain is generally defined by four different types.

A nerve problem (where the nerves themselves are affected by the disease) called peripheral neuropathy is the most common source of foot pain tied to diabetes. Peripheral neuropathy comes in the form of sensory, motor, and autonomic neuropathy.

Sensory neuropathy is the most common and is defined by symptoms where the amount of pain is much greater than the source that is causing the pain. As an example, just touching, or lightly pulling on your socks triggers a painful reaction. Also, with sensory neuropathy you may experience some numbness along with tingling, burning, or even stabbing type pain symptoms.

For many, choosing almost any pair of popular brand name shoes, and wearing them whenever possible, is a fashion statement. However, for someone who is diabetic, the situation is much different. Not just any pair of shoes will do. A diabetic purchasing the wrong pair of shoes may lead to nerve, and vascular damage to the feet. Horribly enough, in the worst case scenario, a doctor may have to amputate the diabetics foot.

The only way a diabetic can prevent this type of situation is by shopping for a special pair of diabetic shoes. Diabetic shoes are not that easy to find; being a product that is exclusive for those who suffer from diabetes they are not available in many stores. A doctor is the best place to start when gathering information on diabetic shoes.

After careful examination, a podiatrist will be able to tell if the patient is at high risk for diabetic related foot problems. Examples of these potential foot problems are abnormal nerve function, as well as foot deformities such as bunions, or hammertoes.

Many people with diabetes have trouble finding a shoe that is comfortable, so diabetic shoes are made to provide protection and be comfortable, diabetic shoes are designed with moldable insoles to reduce the development of ulcers and sores that lead to serious foot problems. Diabetic shoes are often available by prescription through an orthopedic supplier, but they are sometimes sold as a sideline in a retail establishment such as a pharmacy.

All the diabetic shoes are designed to enhance foot function and comfort for diabetic patients; some shoes are Podiatrist-designed which allows for the extra room diabetic feet need to feel ultra comfortable.

As you can imagine, proper foot care is an important part of diabetes management, foot problems are the most common diabetes complication leading to hospitalizations, so most manufacturers are committed to making diabetes foot care as easy as possible, and even some shoes are not that fashionable some of them are not that awkward and unfashionable.

Over the years I’ve observed a common error made by some people living with diabetes. A large percentage of this group wears their shoes too small. Improper footwear and poor fit is a major concern because it has the potential to cause serious injury or harm. Poorly controlled diabetes of long duration can effect circulation and sensation of feet making it difficult to feel whether there is indeed adequate room in the toe area of a shoe. Unfortunately, most people with diabetes often suffer some kind of injury before this problem is recognized. Help of a footwear specialist is essential in making the right choice when buying shoes.

This issue is of great importance because it can help prevent possible long term ailments. Any sign of cuts, scratches and even calluses should be dealt with by a medical professional immediately. A simple blister or a bruised toenail has a potential to cause serious infection especially if there is compromised circulation to the foot. For example, in general, a bruised toe nail will fall off and re-grow in a month or two. However, for someone with diabetes it can take many months. Blisters can become open wounds and require greater attention. Keeping the area clean from infection is imperative. These ailments take a longer time to heal for people with diabetes making them more susceptible to infection. If an infection does occur, extra glucose actually feeds the germs and helps them grow. This combined with the lack of efficient blood circulation (healing power) can lead to gangrene, which can lead to amputation of the toe, foot or even part of the leg. This is why foot care is so important for people with diabetes. Prevention is the key to healthy feet.

Here is a daily care routine:

For people with diabetes, ulcer growing on feet can be common. It is important to heal it soonest possible before it gets worse. Healing needs good foot care and one needs to treat it with antibiotic. Also, one needs to remove the dead tissue that is growing on the feet. For people with foot ulcer, one should try not to walk too much to let the ulcer heal properly. One should also keep the feet clean to prevent more bacteria to infest the wounds, and one should follow the doctor's advice as closely as possible in order for the ulcer to heal faster.

There is a new medication in the market known as Regranex gel that is use to treat people with diabetic condition who have mouth ulcer. This medication only works for those that have enough blood vessels going to the leg. It promotes new blood vessels to grow and also to speed up the healing of ulcer. It is not created directly from blood products and hence safer for use.

It is estimated that over 18 million Americans have diabetes. About 10 million diabetics are between the age of 20 to 60. Most individuals in this age group have type 2 diabetes. With type 2 diabetes the body produces insulin, but it does not produce enough of this hormone or the cells don't respond appropriately to it. The result is an elevated blood sugar and sometimes an elevated insulin level as well. The blood sugar is high because the sugar is not being taken into the cells and utilized for energy properly. Most of the diabetics over the age of sixty have type 2 diabetes.

Serious complications associated with diabetes include stroke, heart disease, blindness, kidney disease, high blood pressure, nervous system diseases and amputations. In 2002 there were 82,000 lower extremity amputations in diabetics. Six individuals out of every 1,000 people with diabetes will have a lower extremity amputation. A slow healing or non-healing open sore (known as an ulceration) on the foot is the most common reason diabetics will end up with a foot or leg amputation. Over 2 million diabetics have ulcerations and one in four diabetics with an ulcer will have an amputation. Unfortunately, over 25% of diabetics have not heard of an ulcer.