Health Information: Diabetics Should Avoid 'Foot Falls' This Summer

Filed in archive Consumer Alert , Diabetes on May 10, 2010

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With nearly 25 million Americans already diagnosed, America is in the throes of a diabetes epidemic quickly gaining in momentum. According to the Centers for Disease Control, one out of every three children will develop diabetes sometime in their life and the American Diabetes Association goes on to say that as many as 57 million Americans are pre-diabetic, meaning their higher-than-normal blood glucose levels have them teetering on the edge of diabetes.

According to New York City podiatrist Dr. John Doolan, the severity of the diabetes crisis is illustrated by a trend he's seeing in his practice: more and more patients are undergoing highly preventable amputations due to complications from diabetes. Adding insult to injury, summer time - the season of family vacations and summer camp - is high season for the infections and injuries that often lead to amputations.

According to Dr. Doolan: "The statistics are staggering: more than 60 percent of all nontraumatic lower-limb amputations occur in diabetic patients" -- pointing out that foot problems are the leading cause of hospitalization among diabetics and adding that with proper treatment, many of those problems and most importantly, amputations, could have been avoided. Further, he adds, amputation rarely improves the patient's condition. In fact, 65 percent of those who undergo diabetic amputation die within five years.



Why is diabetes so hard on the feet?

• Diabetic neuropathies, a family of nerve disorders caused by diabetes, are present in about 70 percent of diabetic patients. Sometimes there are no symptoms and other times there may be tingling or loss of feeling, very commonly in the feet and legs. "In the absence of pain a diabetic patient cannot tell what is going on with their feet. A small cut that became infected goes undetected until an ulcer has developed or a bone infection has set in," explains Dr. Doolan.


• The likelihood that a patient will develop a nerve disorder increases with age, but lifestyle factors such as smoking and alcohol use can also lead to neuropathy.


• Dr. Doolan also warns that diabetes is the most common cause of peripheral vascular disease, which can lead to numbness in the foot or toes, changes in the temperature of the feet and skin infections and sores that do not heal well. Skin infections and sores left untreated are also common causes for amputations.


• Diabetics are likely to develop peripheral vascular disease and smoking, drinking and lack of physical activity increases that risk.

What can you do?

According to Dr. Doolan, the most effective way to ward off diabetic foot problems and prevent needless amputations is by taking an active role in your foot care.

1. Examine your feet everyday. Look for blisters, cuts, scratches, and areas of redness and always check between toes. Use a mirror to get a good look at the underside of feet and if injuries or ulcerations are present, immediately call your doctor.

2. Clean and dry your feet everyday. If a cut is too small to be seen during self-examinations, cleaning it can limit the risk of developing an infection. Make sure to use lukewarm water and properly dry feet afterwards, including between the toes where fungal infections thrive.

3. Do not smoke. Smoking damages and constricts blood vessels, worsens foot ulcers and leads to blood vessel disease and leg and foot infections. Smoking also encourages neuropathy.

4. The podiatrist is your friend. Even the healthiest diabetic patients must see a podiatrist for a comprehensive foot exam at least once a year. Those with complications must go more frequently.

"While it is true that diabetic patients have a very difficult time with foot health and are far more likely to undergo amputations than other patients, it is also true that most who are under the care of a podiatrist will absolutely stay healthy," says Dr. Doolan. "The trick is to maintain care and attend appointments very diligently because issues that can lead to amputation can arise very quickly and can often go undetected by the patient."

Summer time is high season for the foot complications that all too often lead to amputations in diabetic patients, which is why Dr. Doolan urges all diabetics to invest in saving their feet this season.