Diabetes and Foot Problems

No one knows why people develop diabetes, but once diagnosed, the disease is present for life. It is a hereditary disorder, and certain genetic indicators are known to increase the risk of developing diabetes. Type 1, previously known as insulin-dependent diabetes mellitus or juvenile-onset diabetes, afflicts five to ten percent of diagnosed cases of diabetes. This type occurs most frequently in children and adolescents, and is caused by the inability of the pancreas to produce the insulin needed for survival. Type 2, previously called noninsulin-dependent diabetes mellitus or adult-onset diabetes, affects the other 90-95 percent of all diagnosed cases of diabetes, many of whom use oral medication or injectable insulin to control the disease. The vast majority of those people (80 percent or more) are overweight; many of them obese, as obesity itself can cause insulin resistance.


Certain characteristics put people at a higher risk for developing Type 2 diabetes. These include:

  • A family history of the disease
  • Obesity
  • Prior history of developing diabetes while pregnant
  • Being over the age of 40
  • Being a member of one of the following ethnic groups:
      African American, Native American, Latino American, Asian American, Pacific Islander

Treatment
Because diabetes is a systemic disease affecting many different parts of the body, ideal case management requires a team approach. The podiatric physician, as an integral part of the treatment team, has documented success in the prevention of amputations. The key to amputation prevention in diabetic patients is early recognition and regular foot screenings, at least annually, from a podiatric physician. In addition to these check ups, there are warning signs that you should be aware of so that they may be identified and called to the attention of the family physician or podiatrist. They include:

  • Skin color changes
  • Elevation in skin temperature
  • Swelling of the foot or ankle
  • Pain in the legs
  • Open sores on the feet that are slow to heal
  • Ingrown and fungal toenails
  • Bleeding corns and calluses
  • Dry cracks in the skin, especially around the heel

More information
You can also download our Podiatry-at-a-Glance newsletters: A Guide to Diabetic Foot Care and Ulcerations.