Diabetic Foot Infections

Arthritis in the Foot

diabetic-foot-infectionOne potential problem that diabetic patients may encounter is infection. The more that you know about this potential problem, the greater the chances are that you can avoid complications, or at least detect them before they become serious.

Diabetic patients are at high risk for infection for a number of reasons. The immune system of the diabetic patient may not function as well as in non-diabetic patients, especially if the blood sugar is consistently above 250. Circulation problems, if present, may also impair the fight against infection. In fact, infection in the presence of poor circulation (sometimes even apparently normal circulation) greatly increases the chances of gangrene. Almost all amputations in diabetic patients are the result of infection and gangrene. Regardless, at the root of the problem is a break in the skin. The skin is a fantastic barrier against bacteria. If the skin remains intact, no infection develops.

The greatest risk factor in diabetic foot infections, however, is the loss of protective sensation. Once sensation is lost, the skin can become injured without the patient feeling any pain. As already stated, the break in the skin is like opening Pandora’s Box. The loss of sensation in diabetic patients is one more disastrous step in promoting serious infection. The patient is likely to be unaware of the skin break, prolonging the time period during which the area goes untreated. Once the infection develops, the patient still feels no pain, and often continues to walk on the infected foot, delaying treatment even further. Walking on the infection compounds the problem, and spreads the infection deeper and over a wider area.

If you have any breaks in the skin, whether from an ulceration, ingrown toenail, recent cut or scrape, callus or corn treatment, blister, heel crack, or surgery, you must be observant for signs of infection.

  • Although to the general population, infections are generally painful. You may feel pain or slight ache, due to sensation impairment associated with diabetes.
  • You may feel lethargic, feverish, or generally ill.
  • Your blood sugar may become very high or more difficult to control.
  • You may notice painful lymph nodes behind your knee or in your groin.
  • You may notice redness of the foot or red streaks going up the leg (blood poisoning).
  • You will notice swelling of the affected foot.
  • You may notice the affected foot is warmer then the other foot.
  • You may notice pus or drainage.

If you think you have an Infection

  • Call your doctor immediately.
  • Take your temperature before you call the doctor.
  • Stay off your feet until you can see the doctor.
  • Do not go to work.
  • Do not attempt self treatment.
  • Do not take old antibiotics that may be in your medicine cabinet.

Preventing an Infection

Prevention of infection, or at least serious infections and gangrene, may be possible by adhering to the following recommendations:

  • Treat dry skin with recommended skin creams to prevent cracks.
  • Dry well between your toes and use powder between them.
  • Follow the home care instructions for patients with sensation loss, if applicable.
  • Inspect your feet every night.
  • Do not smoke.
  • Exercise, following your doctor’s recommendations.
  • Keep your blood sugar under control.
  • Immediately report to your physician any breaks in the skin.
  • Immediately report to your physician any signs of infection.

If you are under the care of your doctor for an infection

  • Stay off your feet. Avoid walking or standing. Do not go to work.
  • Take prescribed antibiotics as prescribed. Do not stop taking the antibiotic until instructed by your doctor, or if you have a reaction to the antibiotic. Report reactions to your doctor. Always inform your doctor of how much of the antibiotic you have taken.
  • Perform wound care exactly as instructed. Be careful when re-applying your bandages, so that they are not constrictive.
  • Never wear your standard shoe gear. Frequently, a special shoe will be given to you while the infection is being treated.
  • Please monitor your temperature and blood sugar control.

Discuss with Dr. Shumate

It is important to discuss your mobility and foot care problems with Dr. Shumate. He can advise which service or professional support is most appropriate to your needs. Dr. Shumate, after assessing your foot function, may recommend orthoses or insoles to help relieve foot pain and discomfort.