Diabetes is a lifestyle chronic condition that indicates high blood glucose. In this condition, the body is not able to regulate the amount of glucose (sugar) in the blood. Every person's way of management varies and body's reaction to insulin is also different. Every individual has different managements of diabetes. However, if left unchecked, diabetes can cause serious problems too. Foot infections are mostly seen in patients that are suffering from diabetes. These foot infections can be mild, moderate as well as severe in different patients. The most common fungal diabetic foot infection is called Athlete's foot. The diagnosis and treatment of diabetic foot infection can be extremely painful. Therefore, if you have diabetes, having too much sugar in your blood for a persistent period can cause serious complications. Onlymyhealth editorial team spoke to Dr. Paras Agarwal, Consultant - Diabetology, Max Hospital, GurgaonMax Multi, Speciality Centre, Panchsheel Park, about the symptoms, risk factors, treatment and self care tips for diabetic foot infection.
Types of diabetic foot infection
Bacterial infections, fungal infections and local skin infections are common in diabetic patients. If a person has diabetes, it is very common to have a serious fungal foot infection because of compromised immunity due to increased blood glucose values and other factors. Depending on complications of diabetes, patients may have to face many problems such as diabetic neuropathy, which results in decreased sweating, or in the case of long-standing diabetes, where there is blood vessel damage, the healing of the wounds is very poor. There can be cracks in the skin that can lead to a conflation of the infectious organisms, therefore you can also have local bacterial infections, or dermopathy, which can lead to altered pigmentation of the skin. Infection of the nail bed can also occur, which is more likely to happen if you are not cutting your nails regularly, in the right way, if you have uncontrolled diabetes along with other factors such as nerve damage. The main types of diabetic foot infection are:
1. Athlete's foot
Athlete's foot is the most common diabetic foot infection that patients get. It is basically a fungal infection that triggers itching, redness, and cracking. The fungus may enter through the cracks in your skin and result in a bad infection. The doctor has to kill the fungus with medication in order to treat athlete's foot.
Corns develop mostly due to tight or uncomfortable footwear. It is a collection of hard skin at one place on the foot, usually between the toes. Do not go for home remedies or cut the corn on your own at home. It is important to take care of corns, but with your doctor's advice.
A callus is also a collection of hard skin, but on the underside of the foot. These develop due to a person's undistributed weight or tight footwear. Just like corns, calluses also require proper treatment but don't cut it with a sharp object at home.
Cracks on dry skin are common, but in diabetics, this might get serious. Dry skin cracks let germs to enter your foot and you have to take care of the same. Just keep applying moisturizers to keep the skin moist and soft.
Foot ulcers or diabetic ulcers are the deep open sores or gap in the skin of the foot. This happens when small cuts don't heal quickly and take a very long time to recover. Wearing unfitted shoes at such time can result in severe foot infection. This diabetic foot infection is not very common but requires immediate medical attention.
6. Ingrown toenails
Ingrown toenails occur when the edges of the nail grow into your skin. This can be extremely painful, especially in and around the nail. The edge of the nail may cut your skin, cause redness and swelling. It can result in a pus infection too. You have to wear proper shoes and trim your nails gently on time.
Diabetic foot infection symptoms
Dr. Paras said, "Patients can develop corns and calluses without any pain sensation at all, which can be prone to ulcerations. Many times patients complain about the infections in the nail bed (paronychia, altered looking nails), they also have altered sensations due to neuropathy from long-standing diabetes." Below listed are the main symptoms of diabetic foot infection:
- Swelling in foot
- Open sores
- Ingrown toenails
- Cracks in skin
- Bad unusual smell
- Changes in skin colour or temperature
Diabetic foot infection diagnosis and risk factors
The diagnosis of diabetic foot infection is done on the basis of clinical signs and symptoms of local inflammation. The layer of tissues is scraped from the ulcer using a scalpel or by performing a bone biopsy on wounds. Imaging studies are preferred for deep soft tissue purulent collections or osteomyelitis. Dr. Paras said, "It is very important for the patient to take good care of the feet. Early on, due to decreased sweating and sensation in the feet, patients do not have any complaints. They just incidentally notice that they are developing a foot deformity that is leading to corn or some fungal infection might develop between the toes or in the nail bed or the development of an ulcer. Hence, if left untreated for long, they can have local bleeding or discharge or sometimes pain as well." Certain life implications put patients at greater risk. The major diabetic foot infection risk factors are:
- Ignorant hygiene habits
- Walking barefoot
- Wearing tight or pointed shoes for longer periods or not cutting their nails in the right way
- People who are in the habit of smoking might also develop such foot problems since smoking greatly enhances the risk by causing blood vessel damage
Diabetic foot infection treatment and self care tips
According to diabetologist Dr. Paras Agarwal, the whole key for the treatment of diabetic foot is early screening and prevention of the problem. This is because once it starts, it can very difficult to treat. Fungal infections do not respond very quickly to antifungal treatments, they require longer therapy. It is recommended to detect any early signs of neuropathy. It is always advised to the patient to examine the feet, preferably every day and clean them properly every day. Any infection has to be treated aggressively, along with glucose control, proper use of antibiotics, wound care and application of antifungals, wherever required. Gangrene, which occurs due to no supply of blood to certain tissues, is something very dangerous for the body and sometimes occurs in the diabetic foot. In such a case, surgical intervention may also be required to save the foot and sometimes maybe even to save the life of the patient. To avoid or for better treatment of this condition if it arises, the most important thing is to get diabetes under control. It is not the case that every diabetic patient suffers from diabetes foot; with early screening and detection, better lifestyle choices, proper management of diabetes can always prevent any diabetes-related in complication. Here are some self care tips for diabetic foot care for patients:
- Reduce salt intake
- Wear comfortable shoes and socks
- Use bandages, diabetic shoes and diabetic socks
- Keep your feet clean
- Reduce pressure on the foot
- Inspect your feet everyday
- Cut nails gently
- Don't try home remedies without medical advice
- Keep the foot covered/wrapped with dry cloth or socks
- Do not walk barefoot
- Avoid smoking
- Take care of the sugar level
- Visit your doctor for foot checkup regularly
Therefore, these were the symptoms, types, risk factors and self care tips for diabetic foot infection by Dr. Paras Agarwal. In diabetes, even a small cut can make things very complicated for a patient and can even lead to amputation. So, the above mentioned self care tips can help adversely in preventing and in even coping up with severe foot infections. Along with diet, one has be regular with exercise to prevent and treat diabetes. And, random tests cannot tell if you have pre diabetes or not. Fasting glucose and then oral glucose tolerance test tells about the sugar level. And, if someone in your family is suffering from diabetes then you get some signals, so make sure to get tested.
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