Robert Ferry Jr., MD, is a U.S. board-certified Pediatric Endocrinologist. After taking his baccalaureate degree from Yale College, receiving his doctoral degree and residency training in pediatrics at University of Texas Health Science Center at San Antonio (UTHSCSA), he completed fellowship training in pediatric endocrinology at The Children's Hospital of Philadelphia.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Several risk factors increase a person with diabetes chances of developing
foot problems and diabetic infections in the legs and feet.
Footwear: Poorly fitting shoes are a common cause of diabetic foot problems.
If the patient has red spots, sore spots, blisters, corns, calluses, or consistent pain associated with wearing shoes,
new properly fitting footwear must be obtained as soon as possible.
If the patient has common foot abnormalities such as flat feet,
bunions, or hammertoes, prescription shoes or shoe inserts
may be necessary.
Nerve damage: People with long-standing or poorly controlled diabetes are at risk for having damage to the nerves in their feet. The medical term for this is peripheral neuropathy.
Because of the nerve damage, the patient may be unable to feel their feet normally. Also,
they may be unable to sense the position of their feet and toes while walking and balancing. With normal nerves,
a person can usually sense if their shoes are rubbing on the feet or if one part of
the foot is becoming strained while walking.
A person with diabetes may not properly sense minor injuries (such as cuts, scrapes,
blisters), signs of abnormal wear and tear (that turn into calluses and corns), and foot strain. Normally, people can feel if there is a stone in their shoe,
then remove it immediately. A person who has diabetes may not be able to perceive a stone. Its constant rubbing can easily create a sore.
Poor circulation: Especially when poorly controlled, diabetes can lead to accelerated hardening of the arteries or atherosclerosis.
When blood flow to injured tissues is poor, healing does not occur properly.
Trauma to the foot: Any
trauma to the foot can increase the risk for a more serious problem to develop.
Athlete's foot, a fungal
infection of the skin or toenails, can lead to more serious bacterial infections and should be treated promptly.
Ingrown toenails should be handled right away by a foot specialist. Toenail fungus should also be treated.
Smoking: Smoking any form of tobacco causes damage to the small blood vessels in the feet and legs. This damage can disrupt the healing process and is a major risk factor for infections and
amputations. The importance of smoking cessation cannot be overemphasized.