Diabetes is an increasingly regular problem affecting more and more people everyday. Diabetes poses significant health risks for a number of reasons. In the feet diabetes causes a number of problems due to its effect on the vascular system, neurologic system, immune system.
Diabetes is an inability of the body to deliver sugar into the cells. Sugar is delivered into the cells with insulin. In type I diabetes the body does not make insulin. In type II diabetes the cells that make insulin are worn out and unable to make enough of it. The inability of the body to deliver the sugar into the cells causes a high concentration of sugar in the blood. These high sugar concentrations causes damage to the small vessels and nerves. This affects the feet the most bigoted is furthest from the heart and brain and dust has the smallest vessels and nerves. The high sugars also decrease the body's ability to fight infection.
As the nerves become damaged pain can occur in the feet first. This is followed by numbness. Often times patients are relieved when the feet become numb since they are no longer painful. However the numbness can pose its own threat. The patient is unable to feel if something is happening to his or her feet. For instance, a pebble gets into your shoe. Most people would remove the pebble. In the case of a diabetic with poor feeling they don't realize the pebble is in the shoe. They may walk around on the pebble for a significant amount of time. This pebble will eventually wear a hole in their foot. This hole is called an ulcer.
Once you have an ulcer you need a good blood supply to feel that ulcer. The high blood sugars will cause enough damage to the vessels that the wound will not receive enough blood to heal. This means that the patient will have a wound that is unable to heal quickly.
An ulceration is also a source of infection. The skin is the body's first line of defense against infection. An ulceration in the skin is a break in that defense system. So bacteria is able to enter the body. At this point it is the immune system that clears the infection. In diabetics with high blood sugars the immune system is deficient. This will allow the infection to spread. If the infection gets into the blood it can be life-threatening. Often times, if the infection gets into the bone, the bone needs to be removed calling for an amputation.
As a diabetic it is important to keep your blood sugars under control. It is also important to check your feet and shoes every day for any signs of problems. Lastly as a diabetic you should be seen regularly by her primary physician and the podiatrist. Small problems can become big problems very quickly with diabetes. |