Diabetes is a life-altering disease, which can affect each and every part of your body. As a foot doctor, one of my goals is to always help prevent diabetic foot infections or to treat them as quickly as possible, to prevent amputation of a toe, foot, or leg, or even death. Having both diabetes and an infection in your feet can be a scary, and potentially long and drawn-out process to go through. I wanted to put together this guide for those of you that are going through a diabetic foot infection and shed some light on what to expect.
What is a diabetic foot infection?
A diabetic foot infection is just that, an infection of the foot or feet of someone with diabetes. Parts of your foot that can become infected in a diabetic foot include bone, known as osteomyelitis, or soft tissue known as cellulitis. Necrotizing fasciitis, commonly known as "flesh-eating bacteria" is another infection that is seen in the diabetic. Necrotizing fasciitis is infection and death of the muscle fascia, the covering of your muscle.
Why does diabetes cause foot infections?
An infection in your feet while having diabetes is dangerous, and can become life-threatening due to several factors:
1. Diabetic feet tend to have poor circulation
Peripheral Arterial Disease is the name given to disease in the blood vessels, specifically the arteries, outside of the heart. Diabetes attacks the arteries in your legs and feet, which can lead to plaque buildup inside of the arteries, known as atherosclerosis, as well as hardening of the walls of arteries. Poor blood flow in the feet makes it much harder for blood, which carries nutrients and oxygen to reach your feet. If you're feet and legs aren't getting enough blood flow, it is a lot easier for a small nick or cut, to become infected. It is also harder to heal an injury to your feet and legs, increasing the likelihood of diabetic foot infection. Also with poor circulation in diabetic feet, it is much harder for any antibiotics that you take by mouth to reach your feet to fight this infection. Having PAD also increases your risk of developing gangrene.
2. Diabetes weakens your immune system
The high blood sugars seen with diabetes make it much harder to fight infection. Chronic inflammation also is a hallmark of diabetes, and this type of inflammation weakens your immune system by affecting the immune cells responsible for this immune system response, macrophages and lymphocytes. Other types of cells that make up your immune system, like T cells and white blood cells are also impacted by the high blood sugar from diabetes, so they will not work nearly as well as they would in a healthy patient. All of these things increase a diabetic's risk of foot infection.
Another thing that diabetes does in the case of infection, is that the typical signs of infection like redness, swelling, warmer or a hot foot, fever, nausea, vomiting, or diarrhea aren't seen in the diabetic in early infection, if at all. Many times, diabetics will feel fine, even though they have a foot infection in the early stages. This also delays care. Oftentimes, by the time a diabetic patient feels or sees the classic signs of a diabetic foot infection, the infection at this point has become septic, which means the bacteria has reached the bloodstream, which can cause organ failure, and death if not treated aggressively and quickly.
3. Peripheral neuropathy makes it harder for diabetics to feel their feet
The high blood sugars that come with diabetes also attack the nerves in the feet or legs, causing peripheral neuropathy. Peripheral neuropathy makes it much harder, if not impossible to feel the sensation in your feet. Diabetics can get into trouble with foot ulcers, infections, and amputations because if you can't think that something is wrong with your feet, like getting too much pressure in an area of your foot, or a wound on your foot, care is delayed. Delaying care for a diabetic can lead to ulcers, infections, hospitalizations, amputations, and death.
How Do You Treat A Foot Infection For Diabetics?
During your daily diabetic foot check, if you see a wound, a new callus, or a callus that's bloody, or a blister, call your foot doctor or podiatrist immediately. We will take you in immediately and treat the wound before it comes a much bigger problem. Do not soak the wound, as water can carry bacteria and make a clean wound, now an infected one. Place a clean, dry bandaid on the wound instead. not try to treat a diabetic foot infection at home, delays in care can lead to serious infections that require hospitalization and amputation. Treatment options for a diabetic foot infection include:
1. Debridement
Debridement is the cutting away or dead or dying tissue in a wound. Chronic wounds in a diabetic tend to have dead or necrotic tissue or bone that will never become alive again, or be able to heal. Dead tissue harbors bacteria and makes it much harder for a diabetic to fight their foot infection. For these two reasons, tissue or bone is removed in a diabetic foot infection. Debridement can be done in your foot doctor's office, or in an operating room.
2. Antibiotics
Oral antibiotics are a treatment option for the beginning stages of a diabetic foot infection or for someone with a diabetic foot infection that has already been treated with IV antibiotics in a hospital. IV antibiotics are given to people with serious, life-threatening infections. IV antibiotics can continue to be given to someone with a diabetic foot infection after they leave the hospital, but your doctor would have to sign off on this and be sure that you or any patient is the right candidate.
3. Dressing changes
Special dressings, given or suggested to you by your podiatrist or foot doctor, can help prevent further infection in a diabetic foot. Keeping your wound clean, and dry, helps aid in the healing process.
4. Amputation
No one likes to talk about the possibility of amputation, but it is a very real possibility in a diabetic foot infection, especially one that causes hospitalization, or sepsis. Removing the source of the infection for those that have a serious, infection that is deadly, is the first step in getting rid of a diabetic foot infection.
How long does it take a diabetic foot infection to heal?
This is a difficult question to answer and depends on so many factors like how severe the infection is, how is the blood flow or circulation to the infected foot, what other health issues the diabetic patient has, and what treatments are being used. Everybody's journey trying to heal from a diabetic foot infection will be different.
How To Prevent A Diabetic Foot Infection
It is so crucial to the prevention of diabetic foot infection, amputation, and even death that someone with diabetes is checking their feet daily. Again, if you notice any changes to your feet on your daily foot exam, call your foot doctor immediately. Every day that the call is delayed, you are increasing the risk of a life-threatening infection or amputation. Also, tight blood sugar control helps to lower the risk of some of the foot issues seen in diabetics like slower wound healing, poor blood flow, and neuropathy. Keeping your blood sugar within a healthy range makes it much easier to fight infection, and less likely that a foot infection turn into amputation or worse.
Schedule Your Appointment At Direct Podiatry Arizona
Are you a diabetic looking for a foot doctor in the Phoenix area? My name is Dr. Tarr, and I am the owner of Direct Podiatry Arizona in Tempe, AZ. To view my available appointment times, click here.