You might have heard something about how diabetes can negatively impact the health of your feet. Let's explore how and why that is true.
In a person without diabetes, their blood sugar levels are maintained automatically through their pancreas and their liver working in tandem, ensuring that the glucose level in the blood stays within a healthy parameter. In someone with diabetes—either type 1 or type 2—the glucose level is not automatically titrated by our organs. Instead, the sugar in the blood remains higher than expected. When this happens, those sugar molecules act like tiny razor blades in your bloodstream.
If we experienced prolonged and multiple instances of high sugar levels, those little razor blades would create microscopic cuts and tears in the tiniest of our blood vessels. What do our tiny blood vessels feed? Everything in our body, essentially. When we create these \"microvascular\" cuts or tears, our body will respond by creating fibrous scars. When we scar up these areas, there is less and less blood and thus nutrients to those areas. Eventually, these scarred blood vessels will no longer be feeding their target organs or tissues.
Receptors, such as mechanoreceptors, nociceptors, and thermoreceptors. Respectively, these receptors sense pressure and vibration; pain; and the sensation of temperature.
When these receptors die off, often, it is the nociceptors and thermoreceptors that die off first. This leaves us with mechanoreceptors, which make us believe that we still have good feelings in our feet. As we no longer feel pain or temperature, it is easy to step on something sharp or soak our feet in a scalding foot bath without realizing that we are harming our skin.
This also means that we may nick or cut ourselves while performing foot care on ourselves, without realizing that we have caused harm. Generally, we are at a more advanced age when we get to this stage of sensory loss and damage, which means we aren't always in a position where we have direct vision of the areas we are treating on ourselves.
With diabetic neuropathy, often loss of blood supply to our peripheral (feet and hand) skin is also present. This means that we are less able to fight off infections as our white blood cells are unable to maneuver to the wound as easily, but also our ability to deliver nutrients to the affected area is compromised.
For these reasons, it is important to keep up with regular foot care assessment and care. Especially if you are diabetic and have discovered a wound.
Always check your feet daily. Use a mirror if you have to. If you discover a wound, call a healthcare professional to have it assessed as soon as possible. Make sure the healthcare professional is aware that you have diabetes when you are talking with them!