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Treating diabetic foot problems

Healthwise
By Caroline Rea, RN, BS, MS

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When people with diabetes develop foot problems, those problems need prompt treatment so that serious complications do not develop. Even problems that seem minor—like calluses, blisters, cracked or peeling skin, and athlete's foot—need to be evaluated by a doctor. These frequently occur as a result of reduced sensitivity in the feet and may precede more serious infections or foot ulcers if the cause (poorly fitted shoes, excessive weight-bearing, or dry skin) is not identified and corrected.

After a foot ulcer has formed, it will not heal as long as weight-bearing on the area continues. Unless your foot ulcer is infected, your doctor may put a cast on your leg to help the ulcer heal. Keeping your weight off your injured foot is very important. Even when you are at home, be careful to stay off that foot. Cushioned shoes, orthotic inserts, support with a cane or crutches, and in extreme cases, a wheelchair and bed rest may be used to reduce weight and pressure on the feet. Foot infections need to be treated with antibiotics.

If an ulcer or infection becomes severe and the tissue in the foot dies (gangrene), one or more of the toes, part or all of the foot, and sometimes part of the leg may have to be removed (amputated). About 6 out of 1,000 people with diabetes have to have an amputation.1

Bone and joint deformities can develop on the feet, such as toe joint deformities (hammer toe, claw toe, mallet toe) or Charcot foot. Surgery may sometimes be needed to remove bone that is causing a deformity.

References

Citations

  1. National Institute of Diabetes and Digestive and Kidney Diseases (2008). Diabetic Neuropathies: The Nerve Damage of Diabetes (NIH Publication No. 08–3185). Available online: http://diabetes.niddk.nih.gov/dm/pubs/neuropathies/neuropathies.pdf.

Credits

Author Caroline Rea, RN, BS, MS
Editor Susan Van Houten, RN, BSN, MBA
Associate Editor Pat Truman, MATC
Primary Medical Reviewer Martin Gabica, MD - Family Medicine
Specialist Medical Reviewer Barrie J. Hurwitz, MD - Neurology
Last Updated June 3, 2008
Author:Caroline Rea, RN, BS, MS
Last Updated: 06/03/2008