Diabetic foot and skin problems – complications of diabetes

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Because people with diabetes have too high glucose (sugar) in the blood for a long enough period of time, they can develop serious complications, including foot problems as well as skin disorders, cardiovascular disease, stroke, kidney disease, eye diseases and other injuries.


1. Overview
2. How feet can be affected by diabetes?
3. What are foot problems commonly found in people with diabetes
4. How diabetes can affect your skin?
5. The most common skin problems in people with diabetes

How feet can be affected by diabetes?

Diabetes can cause two problems that may affect the feet:

- Diabetic neuropathy – diabetes that is not kept under control can damage nerves. If your leg nerves are injured you might not feel heat, cold or pain. Lack of these sensations is called diabetic neuropathy.

- Peripheral vascular disease – diabetes affects blood flow circulation. When blood flow is inadequate, it will take longer for a wound to heal. Low blood flow to the arms and legs is called peripheral vascular disease. If you have an infection that will not heal because of low blood flow, there is the risk of developing gangrene, which means tissue death from lack of blood.

To prevent the spread of gangrene, the doctor may consider necessary surgical removal of a foot, toe or part of this member. However research concludes that more than half of the amputations performed annually could be prevented by a properly foot care.

What are foot problems commonly found in people with diabetes

Anyone can show some of the leg disorders listed above. But in people with diabetes, these common problems could cause serious infections and possible complications such as amputation.

- Athlete’s foot – This condition involves the presence of fungi that can cause itching, redness and cracks in the skin. Germs can enter through cracks and can cause skin infections. Treatment uses medications to kill fungi. They are available as pills and creams applied directly to the area.

- Fungal infection of nails – nails that are infected with a fungus may become discolored (yellowish-brown or opaque color), it will thicken and become brittle, can detach from the nail bed or could even fall. Dark, wet medium and hot shoes can be good for growth of fungi. In addition, any damage to the nail could be a risk factor for fungal infection. Your doctor may prescribe oral medicines. Treatment might include the periodically removing of the damaged nail tissue.

- Calluses – A callus is a build-up of hard skin, usually located in the lower leg. Calluses are caused by an uneven distribution of weight in the bottom of the foot or heel. Calluses are caused by uncomfortable shoes or presence of skin abnormalities. It is normal a callus formation on foot, but just up to a certain degree. Proper care is necessary if you have a callus. After bath or shower, use a pumice stone to easily remove the thickened tissue. Do not attempt to cut or eliminate the callus with a sharp object.

- Corns – A corn is thickened and hard storage located near bone of a finger or between the toes. Corns are caused by pressure from shoes. Proper care is necessary if you have a corn. After bath or shower, use a pumice stone to easily remove the thickened tissue. Do not use other methods to remove corns at home. Do not attempt to cut or eliminate the corns with a sharp object.

-Dry skin – Dry skin can result if the nerves of the feet and legs do not receive impulses (messages) from brain (due to diabetic neuropathy) to sweat, the process by which the skin is soft and moist. Dry skin can crack, which may allow germs to penetrate within it. Use moisturizing soaps and lotions to keep skin moist and soft.

- Ulcers of the foot – foot ulcer is a crack in the skin or deep wound that can become infected. Foot ulcers can cause minor injuries, cuts that will heal slowly or will be caused by rubbing with some bad shoes. Ask your doctor for advice on how to care these wounds.

- Hammer-shaped toe – is a toe that is bent due to weakened muscles. Weakened muscle determines tendons shorten, causing twisting to one side of the fingers. This condition can be found in the same family and can be caused by wearing shoes too tight or small. Hammer-shaped toe can cause problems with walking and foot problems such as blisters, calluses and sores. The use of splints and shoes with corrective role may help in treating hammer-shaped toe. In severe cases surgery may be required.

- Ingrown nails – These occur when the edges of the nail grow into the skin. Ingrown nails can cause pressure and pain along the nail edges. This can cut skin, can cause redness, swelling, pain, infection and drainage. One of the most common causes of ingrown toenails is pressure from shoes. Other causes are improperly treated fingernails, toenails crowding and after repeated trauma of various activities such as running, walking or aerobics. Proper care and cutting toenails (without cut corners) is the best way to prevent ingrown toenails.

- Plantar warts – plantar warts appear on the sole of the foot and may have small spots in the center. Are painful growths that can develop individually or in groups. Plantar warts are caused by a virus that infects the outer layer of the skin. Do not use drugs without prescription to treat plantar warts. If you are unsure if you have a plantar wart or a callus, it is best that the diagnosis be made by the physician.

How diabetes can affect your skin?

When blood sugar is too high, the body loses fluids, causing dry skin. This happens because the body converts water into urine to remove excess blood glucose.

The skin may be dry due to nerves that do not sweat, especially those in the legs (because of diabetic neuropathy). Keep in mind that sweating helps you to keep the skin soft and moist.

The most common skin problems in people with diabetes

Some of the problems listed below, such as bacterial infections, the fungal itchy skins, are conditions that can affect anyone. However, people with diabetes are more predisposed to develop these conditions, which can cause serious complications.

Some of the conditions listed, such as diabetic dermopathy, necrobiosis lipoid diabeticorum and eruptive xanthomas appear only in people with diabetes mellitus.

Among the most common skin conditions may include:

- Aacanthosis nigricans – is a condition that is focused on darkening and thickening of the skin. Often appear brown potions of skin or easily tanned, sometimes higher on the neck, armpit and groin areas. Occasionally the dark area may appear on hands, elbows and knees. The disease mainly affects overweight people.

- Allergic reactions – allergic reactions to foods, insect bites and medications can cause skin rash or swelling. If you feel that you have an allergic reaction to a drug, contact your doctor. Severe allergic reactions may require emergency treatment. It is very important for people with diabetes to check for rash or swelling in areas where insulin is injected.

- Atherosclerosis – Atherosclerosis is the narrowing of blood vessels due to thickening of blood vessels. In case of atherosclerosis, blood vessels near the heart and the rest of the body, including the skin, are often affected. If blood vessels that supply the skin with blood narrow, the skin changes occur due to lack of oxygen.

- Bacterial infections – there are different types of bacterial infections affecting the skin. These include pot, boil, carbuncles and bacterial infections that can affect the nails. In case of bacterial infections, the affected area is hot, red, swollen and painful. Most bacterial infections require antibiotic in pill form or creams.

- Diabetic dermopathy – diabetes can affect the body’s blood vessels that supply the skin with blood. Changes in blood vessels due to diabetes can cause a skin condition called diabetic dermopathy. The manifestations of this disease include the appearance of scaly patches of brown or reddish color, which appear on the front of the legs. These spots are not painful, itchy or burning and generally no treatment is necessary.

- Digital sclerosis – the word “digital” refers to chilled fingers and toes and the word “sclerosis” refers to thickening, hardening. Therefore, digital sclerosis is a condition in which the skin of the fingers and toes thickens, becomes waxy and is very tight. In this disorder may also occur finger joint stiffness. Treatment consists of maintaining blood glucose control. Lotions and moisturizers may help soften the skin.

- Disseminated granuloma annulare – disease caused by the occurrence of some defined ring-shaped or semicircular forms in certain areas of the skin. These rashes appear on the fingers and ears, but can also occur on the trunk. Rash can be red or red-brown colored. Treatment usually is not necessary but in some cases required the application of steroid medications such as hydrocortisone.

- Eruptive xanthomas – may occur in some individuals when blood glucose levels are poorly controlled and when triglycerides reach extremely high levels. This condition would create some prominent yellow spots. Bumps are surrounded by red and itchy halos, usually being located on the arms, legs, buttocks and back of hands. Eruptive xanthomas treatment consists in maintaining control of blood glucose. The patient may need medication to decrease blood lipid value.

- Fungal infections – a fungus called candida albicans is responsible for the occurrence of fungal infection that affects many people with diabetes. This fungus is accompanied by itching, red rash often surrounded by small vesicles. Among the most common fungal infections are tinea cruris, athlete’s foot, impetigo. Impetigo can occur on the legs, groin, trunk, scalp or the nails. To treat these infections may be necessary drugs that treats infections.

- Itching – itching of the skin is also known as pruritus. This can have several causes such as fungal infections, dry skin or poor blood circulation (the lower legs is most often affected). Lotions may be helpful in maintaining skin moisture and prevent itching, for dry skin.

- Lipoid necrobiosis diabeticorum – change is caused by blood vessels and affects the lower legs. Prominent spots on the skin, yellow and often with a purple edge. Sometimes, the condition involves itching and pain. As long as lesions aren’t involved, treatment is not necessary. If there are open wounds, seek medical advice for treatment.

- Sclerodemie diabeticorum – such as digital sclerosis, causes thickening of the skin behind the neck and upper back. This condition is quite rare and mostly affects overweight people with diabetes. Treatment consists of blood sugar control. Lotions and moisturizers may help soften the skin.




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