The feet are a prime example of how diabetes affects the body. When many people think of diabetes, it is not usually feet that first comes to mind, but lots of people are unaware that diabetics need to make proper foot care just as much a priority as monitoring their blood glucose levels. This is because other than trauma, diabetes accounts for the most cases in which a person has had a foot or lower limb amputated and it is estimated that more than 80,000 people a year lose a leg or a foot as a result of complications caused by diabetes.
How does diabetes lead to amputation? What happens is a combination of damaged or blocked blood vessels and damaged nerves or diabetic neuropathy caused by the effects of diabetes and hyperglycemia. When these conditions are happening simultaneously they set the stage for an injury or infection going unnoticed and getting out of control.
Nerve cells/tissues are very susceptible to damage from the effects of diabetes. If damage to the nerves in your legs and feet is severe enough, it will impair your ability to sense pain in them, and should you develop an infection or suffer an injury, you may not be aware of it until it has become severely infected. You may not think that an ingrown toenail or a small cut on the bottom of your foot is a very big deal, but the warm moist environment created inside someone's shoe as they wear them, can quickly become a breeding ground for bacteria. A cut or injury that has gone unnoticed, opens the door for invasive strains of bacteria, and if the infection becomes severe enough it could easily lead to a toe, foot or even a leg in need of amputation.
Blood vessels are vulnerable to damage from excess glucose in the bloodstream (hyperglycemia) and the smaller the blood vessels are, the more vulnerable they are. In addition if someone also has plaque buildup in the arteries that supply the legs it will further reduce blood flow. If your circulatory system is not flowing freely because of blocked or damaged arteries, veins or capillaries, the cells of your body supplied by them may not receive the necessary oxygen and nourishment they require, which slows or prevents healing. Another result of impeded blood flow is that the white blood cells that fight infection in the body will either be slowed in reaching the infected area or blocked entirely.
When these two conditions are combined in a person with diabetes, they can lead to a variety of problems with their legs or feet, some of which can be quite serious if not treated immediately. Foot problems that are quite ordinary for a person without diabetes can become quite serious to someone that has diabetes. Next we will look at a few that could cause the most concern.