Effects Of Diabetes On The Feet

Patients with diabetes mellitus have a high complication rate with ankle fractures and foot problems. There is a silent change of the vascular supply in both feet, which leads to peripheral vascular disease and a slowed and more complicated healing pattern with injuries, fractures or with arthritis. For instance, in patients with long standing uncontrolled diabetes the pressure from standing on the feet alone can interfere with normal blood supply and a diabetic foot ulcer may devlop.

Also, neuropathic pain is more common as the nerves of the legs have undergone severe changes with a lack of feeling and protection and a loss of the normal protective reflexes. This often leads to major foot pain and other problems that are extremely difficult to treat.

For instance, with ankle fractures in diabetics there is a complication rate of about 40% whereas a control group with non diabetics had none. The complications ranged from osteomyelitis to chronic diabetic foot ulcers to septicemia. For these reasons treatment in diabetics should be very conservative. The physician would utilize mostly non-operative methods as otherwise often below knee amputations have to be done in order to rescue a patient who gets complications from what appeared first to be a minor foot or ankle problem (Ref. 3).

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Disclaimer:

This outline is only a teaching aid to patients and should stimulate you to ask the right questions when seeing your doctor. However, the responsibility of treatment stays in the hands of your doctor and you.

References:

1. ABC of rheumatology, second edition, edited by Michael L. Snaith , M.D., BMJ Books, 1999. Chapter 5.

2. The Merck Manual, 7th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999. Chapter 270.

3. Wheeless' Textbook of Orthopaedics: http://www.wheelessonline.com/

4. The Merck Manual, 7th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999. Chapter 60, p.487.

Last Modified: March 25, 2007