The Delicate Balance of The Diabetic Foot

Copyright (c) 2011 Mountain West Foot & Ankle Institute

On a regular basis new individuals are diagnosed with diabetes and start the process of management of this complex disease. Some already have complications of diabetes, including numbness, tingling, burning or shooting pain of neuropathy, wounds that will not heal or become infected and circulation issues that become increasingly problematic. Whatever the condition of their feet when diagnosed with diabetes, the concerns are real for continuation or progression of these problems. It is important, therefore, that they carefully balance the health of their feet as a stool is balanced with all three legs. Let me further explain:

1. Stool Leg One: Nerve Function. As the nerves are influenced, or affected by the diabetes, they start to malfunction and stop providing the protection or health foot function necessary. Neuropathy typically presents as either complete numbness, tingling or burning to the feet or even electrical shocks or shooting pain. The foot may feel like "cotton on the bottom of the foot", "a piece of leather of the foot" or even no feeling at all. No matter what the presentation , this problem leads to injury of the foot, poor balance or even loss of sweating or oil release to the skin. It is imperative that the nerves be checked on a regular basis to evaluate this leg of the stool to ensure proper balance of your diabetes and foot health. Know that although neuropathy is problematic, usually treatments are available to reduce symptoms and even improve the overal neuropathy.

2. Stool Leg Two: Circulation. Blood circulation is a key component of health, as the blood carries nutrients and oxygen to the tissues of the body and removes toxins or byproducts. Diabetes can decrease the stretch of blood vessels and even calcify the walls of these vessels reducing the effectiveness of blood flow. This is especially problematic to the diabetic foot as the blood flow loss will interfere with the normal tissues of the foot and decrease the healing potential of any wound or injury. Regular evaluation of the blood flow to the feet is imperative to ensure proper foot health and reduce chances of non-healing wounds or infections that progress to foot or leg loss. Know that with proper evaluation, early treatment may improve the circulation to the feet and reduce other symptoms or risks.

3. Stool Leg Three: Functioning Immune System. The body has a special protection system, wound healing system or infection fighting system. This immune system when functioning properly is very effective and producing tissue healing and eliminating infections in the body. In diabetes, the immune cells are unable to function properly and a simple wound becomes a life and limb-threatening problem. Infections progress from simple colonization to sepsis (an infection spreading through the blood) and can even lead to gangrene. Fungus in the toenails may be a simple sign that the immune system is inefficient. Know that regular evaluation of the feet and augmentation of the immune system is imperative and can help further protect your feet and limit associated risks.

As you take the three legs of Nerve Function, Circulation and Functioning Immune System, you can protect your feet and carefully balance the stool of diabetic foot health. Regular evaluation of your feet and legs can strenthen these legs so your health doesn't fall out of balance. You deserve to stay active with healthy, happy feet.


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Brandt R. Gibson, DPM, MS is a foot and ankle specialist in American Fork, Utah. He commonly recommends ways to find quality health products for the foot & ankle. He also enjoys educating you about your feet through a free book.