Diabetes and your feet

Foot ulcers are a very common problem among diabetics. The main predisposing cause is diabetic polyneuropathy. Because the person can't feel their feet properly, they damage themselves if they wear poorly fitting shoes or hit their feet against obstacles.

Some diabetics also have problems with the part of the nervous system that allows you to know unconsciously the position and posture of the various parts of the body. This is called proprioception. Lack of normal proprioception can lead to abnormal weight-bearing and problems with the joints.

Infections commonly result from an ingrown toenail, plantar corn or callus. A fungal infection can also lead to wet lesions between the toes, cracks, fissures and eventually ulcers that then become secondarily infected with bacteria.

Patients with infected foot ulcers often feel no pain because of their neuropathy, and so the problem is detected late. The infection may extend into the deeper part of the soft tissue of the foot and even into the bones.

Deep ulcers, particularly if they show signs of surrounding infection and cellulitis (infection of soft tissue), require treatment in a hospital.