Diabetic neuropathy occurs due to long term exposure of HIGH blood sugars to the nerves. Diabetes damages the nerves due to which their functioning is affected. Besides experiencing hurt, diabetic neuropathy also lessens the ability to feel pain, heat and cold. Loss of sensations also means that you could injure yourself or burn yourself yet do not experience pain at all. This is dangerous as the injury could lead to changes in the shape of your toes and feet, leading to deformities.
- Corn and calluses: Calluses are formed on the base of the feet due to uneven distribution of weight. Corns or calluses are build-up of hard skin, caused by improper fitting shoes or abnormality of shoe. Very thick calluses or corn can press into the foot causing pain. Formation of calluses is a normal mechanism of the body, wherein a thick layer of skin is generated. Pressure or friction on this corn could cause an open wound. In peripheral neuropathy and diabetes, calluses may be covering up much deeper wound or ulceration. If calluses is neglected it can cause ulceration of underlying tissue, may worsen inflammation underneath the skin. It is advisable not to peel or trim the callus on your own, leave that to the expert. Proper footwear and orthotics will help reducing the friction.
2. Fungal Infection of nails: One third of diabetics are estimated to have nail fungus. Due to neuropathy, there is poor blood circulation and impaired nerve function in the limbs leading to loss of sensations. Thus one is more prone to cuts and injuries on the nail, if gone unnoticed can allow fungi to innate the nail. If this remains untreated can lead to serious infection. Sharp infected nails can also pierce the skin around the nails allowing fungi and bacteria to enter. All of these trauma damages the toenail and skin around them. Nails with fungal infection may become discolored (yellowish brown), thick and brittle and may separate from the rest of the nail. Dark moist and warm environment of shoes can also promote fungal infection.
3.Ulceration: foot ulcers causes maximum hospitalization for diabetes than any other complication. Usually occurring on the lower legs or feet, a skin ulcer is an area of skin that is broken down and underlying the tissue. Due to loss of sensation in feet, small cuts, injuries may go unnoticed. Also due to poor blood circulation, healing of the injury may get delayed leading to development of ulcer. Uncontrolled blood sugar leads to slower healing of the ulcer. If left untreated may lead to gangrene and amputation. Once healed, prevention of recurrence of ulcer by taking proper foot care is important.
4.Hammertoe: It is a foot deformity which causes the toe to bend or curl downwards instead of pointing forward. Bend of the toe occurs because of weakening of the muscle. The curling or bending of the toe happens due to tissues that connect muscle to bone, becoming shorter. Hammer toes can cause problems with walking and can lead to forming blisters, calluses and sores.
5. Ingrowth of toe nail: Ingrowth of toenails occurs when the edges of the nail grow into the skin causing pressure and pain along the nail edges. Common causes of this condition are ill fitting shoes, improperly trimmed nails, crowding of the toes, repeated trauma to the feet due to vigorous exercises or activities. There may be redness, swelling, pain and infection as the edge of the nail may cut into the skin. Severe problems with the ingrown nail may require surgery.
6. Bunions: It is a deformity of the feet when the big toe angles in towards the second toe. Often the spot where the big toes joins the rest of the foot may become red and calluses. This often occurs due to abnormal walking habits, ill-fitting footwear or inherited foot type, injury, birth defect, arthritis or certain neuromuscular disorder. Bunions can form on one feet or both.