Podiatrists at the Foot Center in McAllen and Weslaco, Texas specialize in diabetic foot care, including the care of diabetic ulcers. Ulcerations are a result of a breakdown of the skin, causing a wound that results in the loss of tissue. Ulcerations are classified based upon their depth and their cause. Common ulcerations are due to diabetes, ischemia (poor circulation), and venous stasis (varicose veins).
Diabetic ulcers are by far the most common form of ulceration of the feet. They occur in areas of the foot that are exposed to excessive pressure or irritation from the rubbing of the shoes on the skin. Corns and calluses develop as a result of excessive pressure over bony areas of the foot. Over time, the thickened callous that forms can act as an irritant that breaks down the skin under the callous, forming an ulceration. This is more likely to occur if a person with diabetes also suffers from diabetic neuropathy.
Diabetic Neuropathy: The Leading Cause of Foot Ulcers
Neuropathy is a condition that most commonly affects the nerves of the hands, arms, feet, and legs. It causes a loss of or alteration in the ability to perceive pain associated with excessive pressure, temperature, sharpness of objects, or vibration.
As a consequence, corns and calluses that would normally be painful do not cause pain, making one unaware of their condition. Often an infection will also occur, which can result in bone infection (osteomyelitis) or deep tissue infection. If the person also has poor circulation, gangrene can develop.
What Causes Neuropathy?
The most common form of neuropathy occurs in diabetics and is known as diabetic neuropathy. People with diabetes typically have high blood sugars and lack adequate insulin to metabolize it properly. As a consequence, the blood glucose (sugar) abnormally enters certain nerve tissue and damages the nerve. This can occur in any type of diabetes (type 1 or type 2), whether the patient is on insulin, taking diabetic medication, or managing diabetes through dietary changes. The nerve damage that occurs is considered to be permanent.
As a patient develops diabetic neuropathy, they have a greater risk of developing infections and ulcerations. Ingrown toenails can progress to severe infections in people with neuropathy. Simple things like trimming the toenails present a risk to these patients because they may accidentally cut the skin and not feel it.
What Is Peripheral Neuropathy?
Diabetic peripheral neuropathy refers to neuropathy affecting the peripheral nerves found in the feet and legs. This typically begins as a burning sensation in the toes and progresses up the foot in a "stocking distribution."
As the condition progresses, the feet become increasingly numb. Some people feel as though they have a pair of socks on their feet when they do not. Other patients describe the feeling as walking on cotton or a water-filled cushion. Patients often complain of their feet burning at night, making it difficult to sleep. The feet may also feel cold; however, to the touch they have normal skin temperature.
Diabetic peripheral neuropathy is not reversible. The progression of the condition can be slowed or halted by maintaining normal blood glucose levels.
Tips to Protect Your Feet from Developing Ulcers or Infection
- Inspect your feet daily. Be sure to check between your toes and use a mirror to observe the bottom of your feet.
- Do not soak your feet in hot water or use heating pads to warm your feet. This can result in accidental burns to the skin.
- Make sure that your socks are not too tight and your shoes fit properly. It is a good idea to wear diabetic shoes.
- Avoid walking barefoot due to the risk of stepping on something sharp and not being aware of it.
- Inspect the inside of shoes before putting them on to ensure that no foreign object is inside the shoe.
- AVOID or STOP SMOKING, as smoking greatly reduces circulation to the feet.
If you think you need treatment for a foot ulcer, do NOT hesitate – call the Foot Center today. We proudly serve the Rio Grande Valley with two locations in McAllen, Texas (956) 682-4187 and Weslaco, Texas (956) 969-1063. Call now or request an appointment online.