Diabetic foot ulcers

Diabetes affects the feet in many ways. Diabetic neuropathy is one of the symptoms that can occur. Numbness and tingling can spread from the toes to the entire foot and leg. I have patients whom have severe neuropathy and have accidentally stepped on glass, small rocks and other foreign bodies and have suffered severe infections. If the infection spreads up the ankle and leg it's a medical emergency to get IV antibiotics to get rid of the bacteria before it spreads throughout the body. An amputation is at that point necessary to prevent death. 

Diabetes also affects circulation and impedes wound healing. What seems to be a little cut or scrape can turn into an ulcer and take months sometimes over a year to heal. It's easier for diabetics to get infections such as bacterial and fungal. Their immune system is compromised it takes longer to fight infections. Fungus on the skin known as tinea pedis and fungus on the nails known as onychomycosis are both treatable with prescription strength antifungal creams, gels and polish. Lasers can help get rid of fungus as well. Unless the liver function is normal, there is also antifungal oral medication that can be taken. 

Diabetics should see a podiatrist at least every 6 months for a general checkup on their feet. They should not cut their own toenails and calluses because of the risk of cutting too deep causing an infection. The best advice I give to my patients is to control their blood sugar and Hemaglobin A1C. Wear proper shoes not too narrow or rigid with good support and cushion. If something doesn't look right on the feet don't do self treatment, consult a podiatrist right away.