Diabetic Foot Infection: What You Should Know
By Alan S. Peterson, MD
What Is a Diabetic Foot Infection?
It is an infection in the skin, muscles, or bones of the foot of people who have diabetes.
What Causes It?
Over time, high blood sugar levels cause damage to the skin, nerves, and blood vessels in the feet. If you have damages nerves, you may lose feeling in your feet and you won’t be able to feel small cuts, scrapes, blisters, or even pressure from shoes which can cause calluses or other problems.
These minor problems can turn into open sores (called ulcers) or serious infections. Damage to blood vessels slows blood flow to the foot and slows wound healing. This increases the risk of getting an infection that may require the removal of an infected area or amputation of the foot.
How Can I Tell If I Have One?
An ulcer on your foot does not always mean that you have an infection. Infections can cause constant pain (if you still have healthy nerves in the area), redness around the ulcer, warmth and swelling, pus, or an ulcer that does not heal. You should see your doctor as soon as possible if you have any of these signs. Actually any area of your skin that is different or “broken down” probably should be checked.
You should also see your doctor right away if you have fever or chills, have red streaking or redness spreading out from a wound or if blood is constantly draining from the wound. These can be signs from a very bad infection.
How Is It Treated?
Antibiotics are usually used to treat the infection. If you have an infection that has moved into the deeper layers of the foot, such as the muscle or bone, you will need further testing and may need hospitalization and intravenous antibiotics. Any dead or infected tissue will be removed. Some people with poor circulation may need surgery to improve blood flow to the foot and to avoid amputation. Some may need special treatment at the Wound Center.
The wound should start to heal in two to three days. Your doctor will suggest that the wound be checked as often as he or she has indicated to make sure that it is healing. You may need a nurse to help you at home with wound care. You may also have to wear a cast, boot, or special shoes to protect the wound area. Sometimes a soft cast or an Unna boot is required. You should stay off your foot as often as is possible and keep your foot raised.
How Can I Prevent It?
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Control blood sugar levels to prevent damage to blood vessels and nerves.
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Check your feet daily, including between your toes for sores and cuts. Tell your doctor right away if you notice a problem.
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Have your doctor check your feet often.
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Keep your feet clean, dry and warm.
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Always wear shoes that fit well to avoid rubbing and pressure. Don’t go bare foot or without socks, even at home, because this increases the risk of injury.
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Trim your toenails along the shape of the toe and file the nails to remove any sharp edges. Many times for a diabetic it is important for a podiatrist to do this. If you have Medicare, special shoes can be obtained.
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Do not smoke.
Where Can I Get More Information?
Your doctor should always be the first place that you seek information and care for this problem. The American Podiatric Medical Association at 1-800-ASK-APMA or website www.apma.org is also a good source of information. The American Diabetes Association can be reached by dialing 1-800-342-2383 or going on their website at www.diabetes.org.
Dr. Peterson is a doctor of Family and Community Medicine at the Walter L. Aument Family Health Center, 317 S. Chestnut St., Quarryville.
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