Diabetic foot complications represent a growing and serious public health challenge, with perhaps devastating consequences for those living with diabetes. Characterized by chronic, slow-healing wounds, these complications can lead to amputation – a risk increasingly borne by a global population experiencing rising diabetes rates; recent data from Portugal indicates over 1.1 million adults are affected, with nearly 88,500 new cases identified in 2024 alone. This report details the causes, symptoms, prevention, and treatment options for diabetic foot, emphasizing the importance of proactive foot care and diligent diabetes management.
Diabetic foot complications, characterized by chronic, slow-healing wounds on the feet, pose a significant risk of amputation for people living with diabetes. This is a serious concern for public health, as diabetes rates continue to rise globally.
Recent figures from the [Sociedade Portuguesa de Diabetologia](https://www.spd.pt/) indicate that approximately 1.1 million adults in Portugal are currently living with diabetes. In 2024 alone, an additional 88,476 new cases were identified.What is Diabetic Foot?
Table of Contents
Diabetic foot is an umbrella term encompassing a range of foot problems stemming from diabetes. These complications can arise due to:
- The constant pressure the feet endure while supporting body weight.
- Structural changes in the bones of the feet, leading to deformities.
- An increased susceptibility to trauma and injury.
Many individuals with diabetes also experience:
- Diabetic Neuropathy – nerve damage in the legs and feet, causing issues with both motor function and sensation.
- Diabetic Arthropathy – alterations in the position of the joints in the foot.
Factors That Can Lead to Diabetic Foot
Diabetic foot doesn’t develop overnight. It’s often the result of a combination of factors that increase the likelihood of foot injuries. People with diabetes at higher risk include those with:
- Long-standing diabetes.
- A history of foot or lower limb wounds.
- Poor circulation.
- Uncontrolled blood glucose levels.
- A smoking habit.
- Diminished vision, making foot inspection difficult.
- Advanced age.
Symptoms of Diabetic Foot
Diabetic foot can present with debilitating symptoms that require careful monitoring and treatment. The primary symptoms include:
- Wounds and ulcers.
- Numbness or loss of sensation.
- Skin changes.
- Foot deformities.
- Pain while walking.
Why Don’t Diabetic Foot Wounds Heal?
Individuals with diabetes often experience Peripheral Arterial Disease (PAD), which involves the blockage of arteries and restricts blood flow. Reduced blood supply to the feet slows down wound healing and elevates the risk of complications. This highlights the interconnectedness of vascular health and diabetes management.
Risks and Complications of Diabetic Foot
Beyond the symptoms, it’s crucial to understand the risks associated with this condition. Because wounds struggle to heal, they can become entry points for fungi and bacteria, leading to infections. Untreated or aggressive infections can result in severe complications, including amputation of the entire foot (major amputation) or a portion of the limb (minor amputation). In some severe cases, amputation may be the only way to control the spread of infection.
How to Prevent Diabetic Foot
Foot injuries that lead to diabetic foot don’t always cause pain or present obvious symptoms. Therefore, people with diabetes should proactively incorporate preventative foot care into their daily routines:
- Inspection – Examine your feet daily, including between the toes, in a well-lit area.
- Hygiene – Wash your feet daily with warm water, avoiding prolonged soaking (more than 5 minutes). Dry them thoroughly, especially between the toes, with a soft towel – do not rub.
- Heat – Avoid direct heat sources like hot water bottles or heating pads. Use cotton or soft wool socks to warm your feet.
- Hydration – Apply moisturizer to the entire foot, except between the toes.
- Nails – Trim nails straight across with appropriate tools. Filing nails weekly with a cardboard file is also recommended.
- Calluses – Do not attempt to remove calluses at home or in non-specialized settings. Seek professional care for proper treatment.
- Socks – Wear light-colored cotton or soft wool socks and change them daily. Avoid socks with tight elastic or prominent seams.
- Footwear – Avoid open-toed shoes, tight-fitting shoes, and synthetic materials. Custom-made shoes and orthotics are ideal.
Treatment for Diabetic Foot
If you develop a minor foot wound, carefully cleanse it with saline solution, monitor it closely, and contact your doctor or nurse for evaluation. Seek immediate medical attention if the wound shows signs of infection – such as redness, swelling, pus, local heat, or foul odor. In addition to wound care, strict control of diabetes, high blood pressure, and cholesterol is essential. Smoking impairs blood circulation and significantly increases the risk of amputation in people with diabetes, so quitting is vital for protecting foot health.
Conclusion
The feet of people with diabetes require dedicated care and, above all, vigilance. Good diabetes control and management of cardiovascular risk factors (high blood pressure, dyslipidemia, avoiding smoking, maintaining a healthy weight, and engaging in physical activity) are important in reducing the potential for foot wounds. Regular medical check-ups are crucial to prevent treatable conditions from progressing to serious complications.
