Published: 2012-02-27 08:46:52
Author: Anthony L. Komaroff, M.D.
Dear Dr. K: I've heard that diabetics need to take good care of their feet. But what do feet have to do with diabetes?
Dear Reader: Why should keeping your blood sugar levels down have anything to do with your feet? It's an understandable question. The connection isn't obvious.
Both Type 1 and Type 2 diabetes raise blood sugar levels. When blood sugar levels are not kept under control, the nerves that extend into your legs and feet can be damaged. As a result, your feet become less sensitive to touch and pain. In this case, a sore on the skin of your foot could go unnoticed, worsen and get infected.
Of course, your body can heal sores: The immune system comes to the rescue. White blood cells direct the healing response. Most of those cells come to the sore by way of the blood.
Which brings us to the second problem often seen in people with diabetes: blockages in the arteries that bring a blood supply to your legs and feet. Put it together and this is what can happen: You get a sore. You don't notice it's there, because nerve damage keeps you from feeling it. Since you don't notice it, you don't do anything about it, and it gets worse. But your body can't heal it as well or as fast as it should because of the poor blood supply to your feet.
As a result, a simple cut or blister on the bottom of your foot can become so severely infected that a toe or foot must be amputated.