An individual with diabetes can lead to serious foot problems which includes diabetic neuropathy and peripheral vascular disease. Remember that both of these conditions can lead to the following:
- Infections such as bone infections, skin infections and collection of pus
- Diabetic foot ulcers in which the wounds do not heal or become infected
- Gangrene is described as dead tissue caused by the loss of circulation
- Charcot arthropathy involves dislocations and fractures that leads to severe deformities
- Amputation either whole foot, partial foot or below-knee
The symptoms of neuropathy typically include loss of sensation or pain along with tingling sensations. The individual might develop a blister, wound or abrasion but will not feel any pain. There is diminished circulation which causes skin discoloration, pain and changes in the skin temperature.
Depending on the specific problem that develops, the individual might notice swelling, red-colored streaks, discoloration, increased warmth or coolness, wound with or without drainage, injury with no or minimal pain, tingling pain, staining on socks and deformity. In some cases, an individual with infection can experience fever, chills, redness, drainage or even shock.
How these complications develop
It is important to note that neuropathy is linked with metabolic abnormalities of diabetes. Vascular disease is present among those who are diagnosed with diabetes. The ulcers can be triggered by external pressure or rubbing from an ill-fitting shoe, injuries while barefoot walking or a foreign object inside the shoe.
As for infections, they are instigated by the entry of bacteria directly through a break in the skin such as an ulcer, ingrown toenail, area of toenail pressure or areas of skin degeneration in between the bases of the toes. In addition, gangrene can also be triggered by loss of circulation.
Wounds are cleaned and treated with dressings and immobilization using cast boots or full contact casts. As for infections, they are cleaned and antibiotics are given.
The treatment for Charcot joints includes protective immobilization with or without weight bearing. When it comes to gangrene of the toes, observation is required until natural separation or auto-amputation from the foot occurs.
For severe infections such as abscesses, they are managed with immediate surgical removal of the decaying tissue or amputation. The surgical treatment for Charcot foot includes operative stabilization as well as correction of the deformity. As for vascular disease, it can be treated with arterial bypass procedures. Gangrene is managed with partial amputation or below-knee amputation.
Length of recovery
The careful follow-up of individuals with diabetic foot is required since the recovery might worsen despite insignificant warning symptoms. Extended recovery is quite common. The healing of ulcers might require several weeks or even months depending on the size and location of infection, adequacy of circulation and compliance of the individual. In severe infections, it would result to partial foot or below-knee amputation.
Non-healing ulcers will lead to amputation in most cases especially the lower extremities among those who are diabetics. Take note that infections can spread quickly and can become limb or life-threatening.