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Diabetes mellitus is a chronic disease which affects 16 million people in the United States alone. Ulcers occur most often on the ball of the foot or bottom of the big toe, usually where an area of skin has been damaged.
Generally the skin will heal quickly if it has been cut, but in patients who suffer from diabetes the skin on the feet does not heal normally.
Depending on the patient, it may take weeks or even several months for foot ulcers to heal. Diabetic foot ulcers are responsible for more hospitalizations than any other complication related to diabetes. It is also the leading cause of non-traumatic lower extremity amputations in the United States.
The treatment of infections, amputations, and hospitalizations due to foot ulcers cost billions of dollars annually. They may also form as a result of poorly fitted shoes, especially on the sides of the foot. Chronic high blood sugar levels are also associated with serious complications in diabetes sufferers. Although not all ulcers are infected, neglecting them will most definitely result in infections.
Limb-threatening diabetic foot infections are usually polymicrobial, which means that it is caused by several different types of micro-organisms.
For more information on Healing foot ulcers,please read Heal Diabetic Foot Ulcers Naturally. The development of foot ulcers in patients with diabetes mellitus have several components; neuropathy, biomechanical pressure, and vascular supply are but a few. Research has proven that people with diabetes who take good care of their feet and protect them from injury are much less likely to develop foot ulcers. With a proper diet, exercise and correct care, there is hope for those suffering with foot ulcers. For more treatment information on this condition please look at, Secret Diabetic Foot Ulcer Cure Finally Revealed. The Diabetes & You Series will show you proven and effective methods you can use to identify and manage the symptoms of diabetes.
Delivered via email, each issue contains easy to understand information you can use to help you identify and manage the signs and symptoms of diabetes. You will have access to simple facts, tips and information that can help you learn how to effectively manage your diabetes. These are just a few complications that go hand in hand with uncontrolled or poorly managed blood sugar levels.
Mostly, the root cause of diabetic foot complications occur when the nerve supply is damaged, also known as neuropathy which attenuates the sensation in the feet. Of all the foot complications observed in diabetes, foot ulcer is perhaps one of the most grave and expensive complications.
Diabetics should not take foot ulcers lightly as delay in the treatment can lead to greater chances of losing the limb. Most likely, your doctor will take X-rays of the affected foot to verify that the infection has not reached the bone surface. In combination with the tough skin, pressure on that part may lead to damage to the capillaries and the surrounding tissue. According to medical data, of the American diabetic population (which is nearing 16 million), almost one-fourth of them end up with foot problems, courtesy, diabetic nerve damage or neuropathy.
Thus, the patient is unable to perceive sensations, such as those of pressure, heat, cold or even pain. The key feature of diabetics is the intensification of the complication and the slow process of healing. Atherosclerosis or thickening of the walls of blood vessels results in hampered flow of blood to many organs, including feet. Unfortunately, men and women with uncontrolled blood sugar levels are more likely to have severe foot problems which necessitate foot amputation. Though, in diabetic complications joint disorders and related joint pain are less referred as compared to kidney disease and retinopathy, but in certain cases, if joint pain is not treated on time, it may become very serious problem for diabetes patients.
Charcot joint or more commonly referred as Charcot foot, as foot is the part that gets affected the most, though knee, ankle, wrist and hand may also get affected, in a few cases. Charcot joint is commonly observed in people with diabetes since past 15 to 20 years, or in diabetes patients above the age of 50.
Increased blood glucose levels over a prolonged period leads to nerve damage (neuropathy) as one of the diabetes complication, wherein there is a loss of foot sensation, the foot bone collapses, eventually becoming deformed. In diabetes, there is loss of pain sensation and so such injuries or trauma like sprain remain unnoticed and uncured for long, leading to more severe form or state, where joints get majorily dislocated and gradually, the foot is deformed.
Around fifteen percent of diabetes individuals may show Charcot joint development and is specifically observed in people with type 1 diabetes that has been complicated to a state of nerve damage.
Individuals medical history, symptoms and analyzes of misalignments through Magnetic resonance imaging or x-rays technique helps to depict the localized bone density loss, in the affected joint. As early as Charcot joint is diagnosed, the more successful treatment can be achieved that can minimize the probability of ulcer formation, calluses (thickened skin) and permanent deformation.
Early treatment helps in stabilization of the affected joint by undergoing complete rest or making use of crutches or braces to reduce weight pressure over the affected joint. Individualized footwear will need to be worn by the diabetics, for recovering from Charcot joint.
The Center for Wound Care and Hyperbaric Medicine at Wellington Regional Medical Center is pleased to offer specialized services devoted to foot health for diabetic patients. The specialists at The Diabetic Foot are dedicated to staying on top of the leading advances in wound care treatment.
Note:The information on this Web site is provided as general health guidelines and may not be applicable to your particular health condition.
The information, content and artwork provided by this Web site is intended for non-commercial use by the reader. Wellington Regional Medical Center offers a wide range of high quality medical services to residents of Wellington, Florida and surrounding communities. Whether you are getting ready for a procedure at Wellington Regional Medical Center or planning to visit a patient, get the information you'll need to make your trip more pleasant. Stay up to date with the latest news and events at Wellington Regional Medical Center, including health fairs, classes and seminars. This is a fairly common problem where the side or corner of one of the toenails grows in the tender flesh of the toe. If anyone has diabetes or any other problems that may cause circulation to the feet to be poor, then these individuals are at a greater risk for complications. Toenails which are ingrown occur when the nail grows into the fleshy tissue of the toe, mostly the big toe. If left undetected or untreated, this problem with the toenail may cause an infection to the bone underneath and this can often cause a very serious infection of the bone.


Any complications can become particularly severe especially if the individual has diabetes due to the fact that diabetes affects the circulation as well as the supply of nerves to the feet and can weaken it. A primary care physician can normally diagnose the ingrown toenail found not only on symptoms but also a physical exam of the nail and skin surrounding it.
For an ingrown nail which is very slight (pain and redness but no pus), under the edge of the nail the doctor may put cotton in order to separate the nail from any overlying skin.
For an ingrown toenail which is more severe (pain, pus as well as redness), the physician may remove or trim the ingrown part of the nail. For an ingrown toenail which is recurrent, the doctor will probably advise removing a part of the toenail together with the underlying nail bed tissue in order to avoid that portion of the nail from growing back. The doctor may also endorse the use of antibiotics either topical or oral for the treatment of ingrown toenail particularly if the toe is infected or at a risk of becoming infected.
If the toe is infected, then surgical exclusion of either part or the entire nail as well as drainage of the abscess will be necessary.
The physician will then inject anesthetic medication where the toe connection with the foot. The physician then will drain the pus from the end of the toe as well as remove any additional tissue that has grown around the end of the nail. The physician may choose to terminate some cells that could cause the nail to grow back by applying a chemical such as phenol to the skin under the nail. A procedure called a lateral matriectomy is when surgically a portion of the nail bed is removed and is normally performed by a specialist. Antibiotics are normally not prescribed after surgery since draining the abscess will take care of the infection.
For the first 3 days, keep the foot propped up above the level of the heart as much as possible. If the pain is severe, take over- the-counter pain medications, for instance ibuprofen (Advil, Motrin IB) or acetaminophen (Tylenol) to help get rid of the pain until you are able to schedule a visit with your primary care physician.
If you are a diabetic, check the feet each day for any signs or symptoms of an ingrown toenail or other problems of the feet. This website is for informational purposes only and Is not a substitute for medical advice, diagnosis or treatment. An impeded flow of blood and lowered immunity form the fundamental changes which make diabetics prone to various skin ailments (as compared to non-diabetics). This comprehensive article covers the possible skin conditions that may stem from diabetes so that you are able to spot them at the earliest. Damage to the nerves as a result of diabetes may negatively affect the working of the sweat glands, leading to dry skin, mainly on the lower legs or feet. This problem is fortunately easy to control via daily moisturization of the skin, proper use of sunscreen protection and by drinking adequate amounts of water that allow the skin to stay moist for long.
Individuals dealing with diabetes are highly vulnerable to attacks caused by fungal species, especially those initiated by Candida Albicans. Such infections are found most commonly in moist areas of the body; for example, the small area between toes or fingers, in the vaginal, groin or armpit area.
There are a variety of bacterial infections that can be repeatedly seen in patients with diabetes.
Acanthosis nigricans is most frequently associated with insulin resistance (type 2 diabetes), resulting in an escalated amount of insulin in the blood circulation. Mostly, the creases and folds in the body, as seen in the elbows, knees, armpits, under the breast etc, show such changes. Necrobiosis lipoidica diabeticorum is a rare diabetic complication (affects roughly 0.3% of diabetics) which has a strong predilection for adult women. Pathologic degenerative changes that take place in collagen and fat reserves below the skin result in this inflammatory skin disorder. Bullosis diabeticorum, also known as diabetic blister is an infrequent skin condition wherein an individual with diabetes may experience blister formation. The good news is that such blisters subside on their own in a matter of few weeks (2-3 weeks). It appears as a yellow coloured, small sized bump (not more than the size of a pea) and is lined by an erythematous halo. In Disseminated Granuloma Annulare, the diabetic sufferer notices formation of distinct elevated areas on the skin, with an arch or ring form. Atherosclerosis refers to arterial thickening that may result in skin changes (mainly the skin on legs). Diabetes coupled with neuropathy results in the leg and foot injuries which are not noticed by the patient due to lack of pressure or temperature sensation. The vicious interaction of this troublesome metabolic disorder with multiple risk factors leads to many complexities, either involving the skin, leg, feet or significant micro vascular and macro vascular changes. Those living with diabetes are at an increased risk of suffering from diverse foot related problems.
Other than neuropathy, less than sufficient blood circulation and heightened susceptibility of infections also has a role to play in causing foot problems.
After carefully debriding the devitalized skin tissue, you may be put on an antibiotic course.
The effect of this disorder on the capillaries which supply nutrition and blood to the skin of the leg and feet results in thickened skin layer known as callus or corn. If bleeding takes place within the callus area, a haematoma can be visible which causes an itchy or burning sensation within the callus. To prevent its formation, one can wear therapeutic shoes with specially designed inserts that relieve pressure accumulation. Peripheral neuropathy is the most prevalent form of diabetes induced neuropathy which targets the peripheral nerves. Therefore, doctors repeatedly emphasize that diabetic people must under no circumstances ignore the formation of any skin infection or ulcer on the feet.
This change encourages the bacterial and fungal species to establish dangerous foot infections. Some diabetics also complain of pain and discomfort in their calves whilst walking on a hard surface. The vascular changes along with nerve damage make them easy targets for infections and ulcers which in turn may require amputation. The motor nerves that support the joint movement also get damaged and muscles are not able to support the joint effectively. The major signs and symptoms include swollen or loose joints, open sores, ankle-foot deformations and numbness or tingling sensation in joints, mainly foot joint. Then special boots or contact cats are needed to be casted to immobilize the Charcot joint. Severe cases can be resolved by surgery that removes the bony spurs and reshape the deformities of the joint. Every year, chronic wounds caused by diabetes, poor circulation or other conditions keep three to five million Americans just like you from doing the things they love to do. Your individual health status and any required medical treatments can only be properly addressed by a professional healthcare provider of your choice.


Early detection and prompt treatment prevent many skin problems from getting out of control. The yeast like fungal skin infection results in an inflamed, itchy rash, usually encircled by small blisters or scales.
Other common fungal problems associated with diabetes cover Athlete’s foot, ringworm and jock itch. Some of them take up the form of boils, nail infection, carbuncles or folliculitis (infection involving the hair follicles).
This type of diabetic skin complication does not resolve entirely, but losing excess weight certainly improves the condition.
This necrotizing type of skin condition is marked by irregularly formed hard lesions which are raised above the skin surface. The sites where necrobiosis lipoidica diabeticorum is usually seen range from legs, hands, trunk or upper arms. The tender skin is prone to ulceration on slightest of trauma. This particular skin complication is characterized by thick, tight skin on the dorsal surface of both hands and results due to raised levels of blood glucose.
Such blisters typically surface on the feet, legs, arms (extending below the elbow to the wrist), hands or dorsal aspect of fingers.
The sole mode of treatment for diabetic blister is to bring the blood sugar within normal limits. Unlike Necrobiosis Lipoidica Diabeticorum, Eruptive xanthomatosis affects young males who have both, abnormally high triglycerides, as well as cholesterol levels.
It is essentially a red or skin coloured rash which targets those parts of the body which are farther away from the trunk.
As the blood supply to the leg muscles diminishes, in case of any injury or infection, the healing process remains sluggish. With diabetes, even seemingly harmless injuries may take a turn for the worse, leading to serious complications. Once the outermost, protective skin layer weakens or breaks, the underlying deep tissues, become unprotected and opens to infection by bacteria. In addition to this, he or she may also place a protective cast or brace around the ulcerated foot. As compared to unaffected people, the incidence rate of stiff corn formation is increasingly more in those living with diabetes.
If overlooked, the exposure of blood (due to disintegration of callus) may subsequently result in the initiation of an infection or ulceration. As a result, sensory and motor nerves that supply muscles, skin, glands and other organs is drastically impaired.
Neuropathy may also lead to other types of deformities in the feet, namely, hammer toes, bunions or Charcot feet. It has been noted that the process of tissue breakdown advances at a faster rate in such individuals and many a time manages to invade deep enough to reach the bone too. Due to the lack of sufficient nourishment, injuries or sores on the foot require an exceedingly long time to subside.
This particular condition is termed as intermittent claudication. Doctors may recommend daily exercise or prescribe medications to enhance blood circulation to the lower extremities. For such reasons, those diagnosed with diabetes must take utmost care of their feet by controlling blood sugar and taking other preventive measures, such as abstinence from smoking and use of proper, comfortable shoes.
The affected foot is warmer than the other unaffected foot, and there could be development of bony overgrowths called osteophytes that lead to foot deformation. Even bisphosphonates that are known to treat and prevent osteoporosis are known to help diabetics with Charcot joint, from further loss of bone.
Charcot joint can get treated, though treatment usually takes a long time of several months.
The Center for Wound Care and Hyperbaric Medicine at Wellington can help you get your life back. Remember: There is no adequate substitution for a personal consultation with your physician. According to the American Diabetes Association, roughly 33 percent of the entire diabetic population has or is currently living with skin complications induced by diabetes. The affected skin becomes hyper pigmented (it turns dark), hyperplastic (that is, it begins to show incremental growth), and is thick and velvet-like in texture. Other than the hands, joints such as those of the knees or elbows are also targeted, resulting in limited movement of the digits or joints. The common sites affected by eruptive xanthomatosis include the buttocks, arms or even the facial region.
However, this type of rash is easy to handle with certain medicines (mostly a steroid for topical application). This common skin trouble takes the appearance of brown coloured, scaly patches with a circular shape. Such bacterial attacks progress quickly resulting in development of ulcers mostly on the undersurface of the big toe or the ball portion of the foot. Its formation is, in fact, regarded as an initial sign that the person may be at an escalated risk for diabetic foot ulcer too. The most typical symptom of peripheral neuropathy is loss of sensation and numbness in either the hands or feet.
It is thus imperative for such people to carefully observe the feet each day for changes in the colour, swelling, hot spots or deep cracks. It is important to moisturize the skin but make sure you don’t overdo it as surplus moisture from lotions or creams can increase the risk of skin infection. At the Center, a talented team of specialists treat stubborn, chronic wounds, some that have resisted healing after months or even years of traditional treatment. Skin dryness, sluggish blood circulation or development of a yeast infection form some of the prominent causes responsible for itchy skin. Of all the bacterial strains, Staphylococcus is the main culprit behind the development of many skin infections. This type of skin condition mostly affects those who are overweight or diagnosed with diabetes. Mostly noticed in the front aspect of lower legs, diabetic dermopathy remains asymptomatic. The Center's healing rate is over 80 percent and most patients realize complete wound closure in just a few months.



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