Preventing diabetic foot problems

It is not known exactly how blood glucose affects or causes diabetic neuropathy. Keeping tight control of your blood sugar levels may keep you from getting diabetic neuropathy. Tight blood sugar control means a near normal level of hemoglobin A1c (HbA1c). By controlling your HbA1c levels, which show what your blood sugar levels are over a period of time, you can lower your chances of getting neuropathy. This will lower your risk of having foot problems. Even with tight control of your HbA1c levels, it is still possible that you will get neuropathy. But it is much less likely.

Circulatory problems in your legs and a suppressed immune system are also common in diabetes and can severely impair your ability to heal. Neuropathy may initially dull your sensation of pain, preventing you from noticing a potentially dangerous injury. Your body's inability to heal quickly will allow this injury to evolve, unless you notice it and seek medical treatment.

Infections

To prevent foot problems due to infection when you have diabetic neuropathy, you should examine your feet carefully every day to detect any injuries. If you can't see well enough to do this, ask someone to do it for you. By treating your injuries and preventing them from becoming more serious, you may be able to avoid more serious problems, including amputation.

Deformities

If you have neuropathy, your feet are at risk for problems that arise from poor muscular control. If your nerves are no longer able to carry signals that indicate the appropriate motion of your feet and lower legs while you walk, your body may compensate by forcing your feet to adopt unnatural positions while you move. Changing the way you walk increases your risk of getting foot ulcers and deformities. Your feet may become deformed and misshapen if you walk abnormally for an extended period of time. In fact, approximately half of all people with diabetes have a hammer toe or claw toe deformity or a Charcot foot deformity, caused by an abnormal walk. See an illustration of Charcot foot.

To reduce the risk of getting a deformity or other complications with your feet, people with poor sensation in the extremities (peripheral neuropathy) or vascular disease should visit a podiatrist or orthopedic surgeon periodically. This doctor will be able to detect any changes in your feet that indicate a change in the way you walk. If an abnormal walk is detected early, your podiatrist or orthopedic surgeon may be able to equip you with appropriate shoes or inserts that will compensate for the changes in your muscle movement. By taking the pressure off parts of your foot that were not designed to bear such weight, your doctor will be able to minimize your risk of both deformity and injury.