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Education Material for Health Care Professionals: Newsletter Version

THE FEET AND DIABETES


Hammertoes form when a foot muscle gets weak. The weakness may be from diabetic nerve damage. The weakened muscle makes the tendons in the foot shorter and makes the toes curl under the feet. This may lead to sores on the bottoms of your feet and on the tops of your toes. The feet can change their shape. Hammertoes can cause problems with walking and finding shoes that fit well. Hammertoes can run in the family. Wearing shoes that are too short can also cause hammertoes.


Dry and cracked skin can happen due to nerve involvement. Dry skin can become cracked and allow germs to enter.


Conversely, excessive sweating can lead to skin which gets macerated and form an entry point for bacteria.

Athlete's foot is a fungus that causes redness and cracking of the skin. It is itchy. The cracks between the toes allow germs to get under the skin. The infection can spread to the toenails and make them thick, yellow, and hard to cut.


All of these foot problems CAN and MUST be taken care of!

The overall risk of an individual developing a diabetic foot ulcer is
determined by a combination of factors. In general, the risk is higher if:

Neuropathy is more severe (because more sensation is lost)
Peripheral vascular disease is more severe (because there is less circulation to bring enough oxygen to repair tissue damage)
There are coexisting abnormalities of the shape of the foot which make the local effects of neuropathy or vascular disease more severe (because it increases local pressure and callus)
The person is unable to practise reasonable self care to maintain general condition of the feet and to prevent trauma (because there are more chances of damaging the feet)
The diabetic control is very poor (because of susceptibility to infection and poor wound healing)
There is a past history of foot ulceration due to diabetes (because the above factors often persist)
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