Tuesday, December 14, 2010

What Causes Diabetic Foot Ulcers?

It’s the sign of advanced diabetes that diabetics dread, ulcers of the feet and lower legs. The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDKD) has published estimated that one in six diabetics oeventually develop a foot ulcer, and 6 out of every 1,000 diabetics will undergo an amputation. Foot ulcers are most common in diabetics who have neuropathy, and neuropathy is most common in diabetics who have high blood sugars after meals, but normal or “OK” blood sugars in the morning. Letting blood sugars get too high during the day is a leading contributor to diabetic foot disease.

Before diabetics develop foot ulcers, they usually have diabetic neuropathy of the feet. This condition can manifest itself as a simple feeling like the foot is “asleep,” or maybe a tingling or burning sensation, usually worse at night. The condition can progress so that the feet feel the same way your mouth does after you get a shot of anesthetic at the doctor’s office, only the feeling never goes away.

Loss of sensation in itself is something diabetics can deal with, as long as they can see their feet. The problem comes when a diabetic does not feel a broken bone or notice an infection after a cut or a scrape. Clogged capillaries cannot carry immune cells to clear out infection, and gangrene can set in. Treating gangrene without surgery is not impossible, but it is very difficult.

Doctors at the Hospital General in Durango, Mexico have published a study that almost 95 per cent of their diabetic patients presenting foot ulcers suffer low magnesium levels. Another study found that low magnesium levels are associated with a 300 per cent greater risk of foot ulcers in type 2 diabetics. When diabetics take supplemental magnesium (something to be done carefully and in moderation, since, like Milk of Magnesia, magnesium supplements can cause diarrhea), modest improvement usually comes about in 3 or 4 days. It lasts as long as you take the supplement, or eat magnesium-rich foods like greens or spinach every day.

Recent reader questions:

Q. What's the significance of bites or bumps just on toes of a diabetic?

A. I can't diagnose you, but my question would be whether there weren't really bites further up the foot and leg and only the toes were not healing quickly? Toes are the first part of the foot, usually, to show diabetic changes.

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