Diabetic Foot Infections

Infections are often a problem in persons with diabetes, since they have difficulty fighting off bacteria that enter the skin from cuts or other wounds. This is due, in part, to certain deficiencies in the activity of white blood cells. Apparently, uncontrolled high glucose levels impair normal immune responses to bacterial invaders. The result can be an overwhelming infection in the foot.

Without the ability to feel pain or without the ability to deliver white blood cells to the site of injury, infections can frequently become serious in a short period of time. The first sign of such serious infections might be very high blood sugars or flu-like symptoms, which I call the "Diabetic Foot Flu". Unfortunately, fever is often absent or delayed in diabetic foot infections. Therefore, when you develop a fever, proper attention must be given to your situation immediately. Infections are the most frequent reason for hospitalizing diabetic patients and can progress to bone involvement in a relatively short period of time. Deep infections almost always require some type of surgery for treatment, so it is best to catch these problems early and avoid this serious complication.

Foot deformities such as hammertoes, bunions, and metatarsal disorders are common in the general population, but have a special significance in the diabetic population. When neuropathy or poor circulation is present, these deformities place the foot at increased risk for developing pressure lesions (corns, calluses, blisters, ulcerations, etc.) from tight shoes or simple walking.
Serious infections can result if these lesions go untreated.

Special deformities can occur in persons with neuropathy and very good circulation. A Charcot joint, resulting from trauma to the insensitive foot, causes the foot to collapse and widen. This very destructive condition is often first heralded by persistent swelling and redness, increased warmth in the affected foot, some mild to moderate aching, and an inability to fit into your usual shoes. If this should occur it is extremely important to stay off your foot and immediately see your podiatric physician. Neglect of this complication can lead to continued collapse of the foot, progressive deformity, and subsequent ulceration.

Diabetes can cause changes in the skin of your foot. At times your foot may become very dry. The skin may peel and crack. The problem is that the nerves that control sweating in your foot no longer work.

After bathing, dry your feet, and seal in the moisture that remains with a thin coat of a lubricant. You can use plain petroleum jelly, unscented hand creams, or other such products.

Do not put oils or creams between your toes. The extra moisture can lead to infection. Also, most health care providers believe you should not soak your feet.

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