The Diabetic Foot

The other day, whilst perusing whatever book it was that I was reading, I came across something called - neuropathic ulcers. This was linked with peripheral neuropathy. It just so happened that in my week off I was faced once again with diabetes. Such is the topic of diabetes that people either get bogged down by this big topic...or they embrace it whole-heartedly.

The diabetic foot, I reckon is a term either for the diabetic person with a foot or a condition that can develop in diabetics resulting in a specific foot problem or problems of the feet that are particular to those that suffer with diabetes. Any complications that develop are probably in the late stage of diabetes, but as many will say, many complications can be prevented overall or at least greatly delayed.

The problem with diabetes is the effect it has on the nervous system within the body. Sugar or sweet blood, which the diabetic individual aims to control with either insulin or diet, has overtime, in cases where there is poor control especially, has the effect of damaging the delicate structure of the nerve.

We know that nerves, have in essence many main functions.

That of light touch, pressure, pain, temperature and joint position and vibration sense, in addition to power, tone and movement.

In a diabetic individual, any one of these functions may fail if the nerve that is affected that carries out that particular function.

Often, what tends to happen is that there is what is called a peripheral neuropathy. Ie the nerves that have left the spine, travelling out to the respective organ or skin or muscle - is damaged. The process of this damage is rather complicated and has much to do with glycated proteins and maybe even free radical formation...but i'd rather not say...and this is where my revision is nonsense and needs me to look over it again....suffice to say that damage occurs.

So the diabetic foot - neuropathic ulcers...develop as a result of the individual not feeling their feet or pain in their foot or the pressure applied to their foot.

The management of an unaffected foot of a diabetic individual is beyond crucial. Managing it well can be the difference between preventing the formation of an ulcer or damage to bone or ligaments or blistering of the skin, to all of these things and the long term complications and difficulties in its healing.

Edited:

I was talking the other day to someone about this....and I've come across terms - 'neuroischaemic ulcers'

I learnt the following. That not only are the nerves affected : proprioception (hence joint injury or over usage of joints beyond what they are normally capable of..particularly the over-flexion or over extension of a joint - contributes to Charcots joints, which themselves im not sure .. get painful, poor healing due to poor microvasculature - infection>?)

But on the microvasculature : this is perhaps where the term neuroischaemic comes along -- poor healing of the skin - be that from a small injury, or to the tissue, or poor healing in infection due to poor blood supply.

And then high glucose levels too - encourage infections and generally affects or reduces the effectiveness of the immune system or inhibits the immune system...

Little nitty gritty things like this annoy me...when I don't know specifics...REALLY annoys me. But so far, this i believe is the general gist of things.

I need this to be clarified though.