Diabetes-Related Foot Conditions

Some people with diabetes develop numbness in the feet or poor blood flow. That can make it difficult to notice blisters, sores and cuts. Undetected and untreated wounds can quickly become infected, leading to complications and sometimes amputation. There are many strategies to protect your from wounds and infection.What are diabetes-related foot conditions?People with diabetes often have problems with their feet. They may develop foot develop sores, deformities and infections more easily.If not treated quickly, a foot ulcer or blister on a person with diabetes can get infected. Sometimes a surgeon must amputate (remove) a toe, foot or part of the leg to prevent the spread of infection.Who might have problems with diabetes-related foot conditions?Foot problems often occur in people with diabetes, especially among those who have:Nerve damage or poor blood flow in the feet.Trouble managing blood glucose levels over long periods, including frequent episodes of hyperglycemia (blood sugar that’s too high).A BMI of more than 25 (overweight/obesity).Had diabetes for a long time.High blood pressure or high cholesterol.How common are diabetes-related foot conditions?The chance that a person with diabetes will develop a foot condition at some time in their life is about 15%.What are the symptoms of diabetes-related neuropathy?The signs of diabetes-related neuropathy may include:Darkened skin on the affected area.Diminished ability to sense hot or cold.Loss of hair in the area.Numbness.Pain.Tingling.If diabetes-related neuropathy leads to foot ulcers, symptoms to watch out for include:Any changes to the skin or toenails, including cuts, blisters, calluses or sores.Discharge of fluid or pus.Foul smell.Pain.Redness.Skin discoloration.Swelling.How are diabetes-related foot ulcers treated?Care for diabetes-related foot pain may involve a doctor who specializes in the feet, called a podiatrist. Treatment may include:Cleaning the wound.Draining any fluid or pus from the ulcer.Removing or cutting away dead or infected tissue (called debridement).Applying special bandages and ointments to absorb extra fluid, protect the wound and help it heal.Prescribing a wheelchair or crutches to take weight off the affected foot (called offloading).Prescribing oral or IV antibiotics to manage and eliminate infection.Depending on how severe the infection is, your healthcare provider may recommend hospitalization. Sometimes amputation is necessary to prevent infection from spreading to other parts of the body.



What Are Insulin Pumps?

Everyone with type 1 diabetes and many people with type 2 need to take insulin to manage their blood sugar levels. For now, there are two options: injecting it with a needle or pen, or using an insulin pump.An insulin pump is a small computerized device. It delivers insulin through a thin tube that goes under your skin.How an Insulin Pump WorksThe device releases insulin almost the way your body naturally would: a steady flow throughout the day and night, called basal insulin, and an extra dose at mealtime, called a bolus, to handle rising blood sugar from the food you eat. You program the pump for both basal and bolus doses. If you eat more than normal, you can program a larger bolus to cover the carbs in your food. A bolus can bring down high blood sugar at other times, too.The pump is about the size of a smartphone. You attach it to your body using an infusion set: thin plastic tubing and either a needle or a small tapered tube called a cannula you put under the skin. The place where you put it in -- your belly, buttock, or sometimes thigh -- is called the infusion site. Some pumps come with inserters for easier placement even in hard-to-reach areas.Insulin pumps use short-acting and rapid-acting insulin, but not long-acting, since the pump is programmed to deliver a small amount continuously to keep your blood sugar levels even.Advantages of an Insulin PumpYou’ll need fewer needle sticks. A pump requires one shot every few days when you change your infusion set.A pump is more accurate than shots, helping you better manage blood sugar levels.You’ll have fewer blood sugar lows, which is important if you often have hypoglycemia.It may improve your A1c levels.Dosing for meals and snacks is easier.It’s easier to plan for exercise.It’s easier to bolus.It helps manage early morning high blood sugar, also called the “dawn phenomenon.”One thing to keep in mind: You’ll always need to have regular injectable insulin on hand in case the pump stops working.Disadvantages of an Insulin PumpYou’ll need to enter information into the pump all day and change out the infusion set every few days.You’ll need to commit to using it safely, including checking your blood sugar to make sure the pump is working right. Otherwise, you risk a life-threatening problem called diabetic ketoacidosis (DKA).You’ll need training to learn to use the pump, which means several visits with your health care team or a full day of outpatient training.Pump supplies can be expensive.An insulin pump may not be right for you if:You don’t want to wear a device that lets people know you have diabetes.You don’t like the feeling of wearing a device.You’re not comfortable operating the pump.You don’t want to check your blood sugar at least four times a day.You’re not sure you want to do the work to figure out insulin dosing, carbs, and physical activity.Which Pump Is Best?All insulin pumps have benefits and drawbacks. Your choice will depend on what’s most important to you. Do you want an easy setup? Low up-front cost? Ease of use? Since most insurance companies will replace your pump only after several years of use, it’s important to find one that works for you.