What is diabetes?
Diabetes is a disease of the pancreas.
The pancreas produces a substance called insulin. Insulin plays an
important role in the distribution and use of the energy the body
needs to function.
When food is digested, much of it is broken down into a simple
sugar called glucose. Glucose is the energy source the body's cells
need to keep them functioning. Insulin enables the glucose to enter
the cells. The digestive process will continue to create glucose
whether or not the pancreas makes insulin. When the pancreas isn't
making enough insulin, the bloodstream begins to get overloaded
with glucose. This is called "high blood sugar" and is considered
the prime indicator of diabetes.
There are three levels of diabetes: The pancreas does not make
any insulin; the pancreas makes a small amount of insulin; the
pancreas makes insulin but it does not work right. Any level can
cause complications in other areas of the body. One of the most
common areas of concern is the feet.
How can diabetes affect my
feet?
Diabetes can contribute to foot problems in
two ways: diabetic neuropathy
which is a nerve disorder that causes numbing and pain in the
hands, legs and feet, and damage to internal organs
and poor circulation to the feet.
What are the foot problems can be
caused by diabetes?
Diabetic peripheral neuropathy
can cause toe deformities, the collapse of the arch, and dry skin.
The foot often becomes wider and shorter, which puts pressure on
parts of the foot that are less protected. This can cause ulcers to
develop. Injuries such as scrapes or cuts can go unnoticed, which
can also lead to foot ulcers and infections. If left untreated,
infections can lead to gangrene and amputation. Poor circulation
means a reduced blood flow, which can result in a lowered ability
to fight infection and heal wounds. If an infection gets into the
bone it can also lead to amputation.
Fifteen percent of all people with diabetes will eventually have
a foot ulcer, and six out of every 1,000 will have an amputation
(50,000 per year). However, doctors estimate that nearly three
quarters of all amputations caused by poor circulation and diabetic
neuropathy can be prevented with proper foot care.
Understanding diabetic
neuropathy
There are three types of neuropathy:
Diffuse (peripheral), which affects the limbs; diffuse (autonomic),
which affects the internal organs; and focal, which affects the
eyes, ears, facial muscles, pelvis, lower back, thighs, and
abdomen. While the exact cause of diabetic neuropathy is unknown,
researchers believe that higher blood glucose levels will lead to
the onset of neuropathy more quickly. A study by the National
Institute of Diabetes and Digestive and Kidney Diseases proved that
keeping blood sugar levels as close to normal as possible slowed
the onset and progression of neuropathy. Generally, neuropathy will
develop within the first 10 years after diabetes is diagnosed. The
risk for developing the disease increases the longer you have
diabetes.