It is no secret that Diabetes is at epidemic levels in our country. I run a clinic specializing in Diabetic foot and ankle wounds and thousands of foot wounds every year. Why does Diabetes effect the feet? Although this answer could be very lengthy, essentially, elevated blood sugars effect every function of our bodies. What most people don´t know is that elevated blood sugars over time (sometimes 10 years), damages the nerves in the feet making them “numb”. So numb, in fact, that literally a “neuropathic” person could step on a nail and not feel it. Happens everyday. This also means that even a simple callus on the bottom of a foot can cause a significant problem. A callus can act just like having a pebble in your shoe all day long. What would happen? A wound. Now this wound is exposed to the environment where bacteria exsists and therefore the possibility of infection. This can literally happen in a single day and require surgical debridement or even amputation.
Now, let´s add impaired circulation. Typically, a wound anywhere on our body requires an increase in blood flow to the area for adequate healing. Diabetes can lead to a decrease in circulation (to the foot especially) and therefore poor healing potential. After all, the foot is the furthest from the heart.
So we have covered two of the basic issues leading to a Diabetic foot wound – neuropathy (electricity) and circulation (plumbing). So, in a diabetic body (the house) we have faulty electricity and plumbing. Add damage to the foundation (the feet) and we have problems. For instance, a bunion or hammer toe, will produce a bony prominence on the bottom of the foot. This prominence creates an increase in pressure at that point, much like a high heeled shoe has very high focal pressure at the heel. This is where a callus would form to try to protect the area. If you have good sensation, you pad this area or change the way you walk to avoid it. If you can´t feel it, the callus grows and becomes that “pebble” in the shoe.