The Diabetic Foot

Diabetes is a serious disease that can develop from lack of insulin production in the body or due to the inability of the body’s insulin to perform its normal everyday functions. Insulin is a substance produced by the pancreas gland that helps process the food we eat and turn it into energy.

25% of all Canadians with diabetes will develop foot problems related to the disease. Diabetic foot conditions develop from a combination of causes including poor circulation and neuropathy.

Diabetes often leads to peripheral vascular disease that inhibits a person’s blood circulation.

Proper footcare is especially critical for diabetics because they are prone to foot problems such as:

• Loss of feeling in their feet
• Changes in the shape of their feet
• Foot ulcers or sores that do not heal

Simple daily foot care can prevent serious problems.

Toenail Fungus

Toenail fungus, known by physicians as Onychomycosis, affects about half of Canadians by the age of 70. It is relatively rare in children, but the incidence increases with age. Fungus infections occur when microscopic fungi gain entry through a small trauma in the nail, then grow and spread in the warm, moist environment inside the patient’s socks and shoes.

Toenail fungus can be picked up in damp areas such as public gyms, shower stalls or swimming pools, and can be passed among family members. Athletes and people who wear tight-fitting shoes or tight hosiery that cause trauma to the toes or keep the feet from drying out are at higher risk.

Because it is difficult to treat or eradicate toenail fungus, it is a good idea to try to prevent it. It helps to wear protective shoes or sandals in public showers, pool areas and gyms, and to avoid borrowing someone else’s shoes or sharing socks or towels with someone who has toenail fungus.

Ingrown ToeNails

Known to physicians as onychocryptosis, ingrown toenails are a common, painful condition that occur when skin on one or both sides of a nail grows over the edges of the nail, or when the nail itself grows into the skin.

Ingrown toenails develop for many reasons. In some cases the condition is congenital, such as toenails that simply are too large. People whose toes curl, either congenitally or from diseases like arthritis, are prone to ingrown toenails. Often trauma, like stubbing a toe or having a toe stepped on, can cause a piece of the nail to be jammed into the skin. Repeated trauma, such as the pounding to which runners typically subject their feet, also can cause ingrown nails.

ngrown toenails should be treated as soon as they are recognized. In many cases, people with uninfected ingrown toenails can obtain relief with the following simple regimen:

• Soak the feet in warm salt water
• Dry them thoroughly with a clean towel
• Apply a mild antiseptic solution to the area
• Bandage the toe

Cutting toe nails properly goes a long way toward the prevention of ingrown toenails. Using a safety nail clipper, cut the nails straight across, so that the nail corner is visible.

Calluses

The formation of calluses is caused by an accumulation of dead skin cells that harden and thicken over an area of the foot. This callus formation isthe body’s defense mechanism to protect the foot against excessive pressure and friction. Calluses are normally found on the ball-of-the-foot, the heel, and/or the inside of the big toe.

Calluses develop becuase of excessive pressure at a specific area of the foot. Some common causes of callus formation are high-heeled dress shoes, shoes that are too small, obesity, abnormalities in the gait cycle (walking motion), flat feet, high arched feet, bony prominences, and the loss of the fat pad on the bottom of the foot.

Many people try to alleviate the pain caused by calluses by cutting or trimming them with a razor blade or knife. This is not the way to properly treat calluses. This is very dangerous and can worsen the condition resulting in unnecessary injuries. Diabetics especially should never try this type of treatment.

An effective orthotic transfers pressure away from the “hot spots” or high pressured areas to allow the callus to heal. The orthotic should be made with materials that absorb shock and shear (friction) forces. Women should also steer away from wearing high-heeled shoes. As always, surgery should be the very last resort.