About 30 percent of people with diabetes who are older than 40 develop medical problems with their feet. The damaged nerves and poor blood circulation that often accompany elevated blood sugar ensure that there is no such thing as a minor cut, scrape, bump, or bruise on the foot when you have diabetes.
While blood-sugar problems can create a dizzying range of hard-to-treat complications, lower-limb diseases that are not properly treated can deteriorate so quickly and so badly that doctors have no other choice but to eliminate the problem altogether. That's another way of saying that people with diabetes account for 60 percent of all lower-limb amputations in the United States. In fact, a patient with diabetes is 10 to 30 times more likely to have a lower limb amputated than a person without the disease.
For two sturdy performers who take a daily pounding, the feet are surprisingly complex structures. Combined, your two feet have more than one-quarter of the bones in your body -- 26 each. Although they form the foundation for the body, the feet aren't static blocks but agile and dynamic machines of movement, with more than 100 tendons, muscles, and ligaments apiece. Given their workload and all those moving parts, it's not surprising that about 75 percent of Americans experience one foot condition or another in their lifetime, according to the American Podiatric Medical Association. (Podiatrists are foot doctors.)
The Feet and Diabetes
Chronically elevated glucose levels can damage the nervous system, the wiring that transmits signals from the brain throughout the body. The nervous system works the other way, too: It detects information about the environment and how it affects the body through the five senses. Damaged nerves, or neuropathy, can lead to an array of physical problems and disabilities anywhere in the body. But nerve injuries and other diseases that affect the feet (and lower legs) may be the complications most frequently associated with diabetes. What's more, the various foot conditions linked to diabetes may be the complications patients dread most.
Annoying and painful symptoms can occur when the brain can't successfully send messages to the feet. But the even greater threat posed by diabetic neuropathy happens when the feet can't send information to the brain because they've become numb from overexposure to blood sugar. What do your feet have to report to mission control? Plenty. But cuts, bumps, and other injuries that once would have made you wince or howl in pain go unnoticed when your feet lose their feeling.
To make matters worse, dulled nerves probably aren't your only problem if you have diabetes. The disease can also cause poor blood circulation. Like the heart's arteries, blood vessels anywhere else in the body can become stiff and narrowed. In fact, 1 in 3 people with diabetes who are older than 50 has clogged arteries in the legs, a condition known as peripheral artery disease, also called peripheral vascular disease. Narrowed arteries diminish blood flow to the lower legs and feet, which can cause pain if you're walking long distances. More ominously, the loss of blood flow to the feet can prevent wounds and sores from getting the oxygen and nutrients they need to heal, allowing them to grow and spread.
So while occasional bumps, blisters, or cuts are trivial medical concerns for most people, for diabetes patients these minor injuries can turn serious in a hurry. Left ignored and untreated, minor sores on the skin of the foot can turn into severe problems with potentially devastating consequences -- namely, foot ulcers.