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Diabetic foot infections are infections that can develop in the skin, muscles, or bones of the foot as a result of the nerve damage and poor circulation that is associated with diabetes.

People who have diabetes have a greater-than-average chance of developing foot infections. Because a person who has diabetes may not feel foot pain or discomfort, problems can remain undetected until fever, weakness, or other signs of systemic infection appear. As a result, even minor irritations occur more often, heal more slowly, and are more likely to result in serious health problems.
With diabetes, foot infections occur more frequently because the disease causes nervous system changes and poor circulation. Because the nerves that control sweating no longer work, the skin of the feet can become very dry and cracked, and calluses tend to occur more frequently and build up faster. If not trimmed regularly, these calluses can turn into open sores or ulcers. Because diabetic nerve damage can cause a loss of sensation (neuropathy), if the feet are not regularly inspected, an ulcer can quickly become infected and, if not treated, may result in the death of tissue (gangrene) or amputation.
The risk of infection is greatest for people who are over the age of 60 and for those who have one or more of the following:
  • poorly controlled diabetes
  • foot ulcers
  • visual treatment for changes in the retina
  • kidney or vascular disease
  • loss of sensation (neuropathy)
Causes and Symptoms
Bacteria can cause an infection through small cracks (fissures) that can develop in the dry skin around the heel and on other parts of the foot or through corns, calluses, blisters, hangnails, or ulcers. If not treated, the bacterial infection can destroy skin, tissue, and bone or spread throughout the body.
Common sites of diabetic foot infections include the following:
  • blisters, corns, or callouses that bleed beneath the skin
  • bunions, hammertoes, or other abnormalities in the bones of the foot
  • scar tissue that has grown over the site of an earlier infection
  • foot ulcers caused by pressure, nerve damage, or poor circulation (Ulcers occur most often over the ball of the foot, on the bottom of the big toe, or on the sides of the foot due to poorly fitting shoes.)
  • injuries that tear or puncture the skin
Without proper treatment, diabetic foot infections can lead to serious illness, gangrene, amputation, and even death if the infection spreads throughout the body. If treated properly and the patient practices good foot care, the prognosis is generally optimistic.
There are many things that a diabetic individual can do to prevent the occurrence of foot infections, including the following:
  • control blood glucose and do not allow it to get too high
  • avoid smoking
  • keep blood pressure and cholesterol under control
  • exercise to stimulate blood flow
  • keep feet clean, dry, and warm
  • check your feet every day for blisters, scratches, and skin that is hard, broken, inflamed, or feels hot or cold when touched
  • after bathing, carefully dry feet and apply thin coat of petroleum jelly or hand cream to prevent dry skin from cracking
  • use a pumice stone and emery board to trim calluses
  • do not neglect an ulcer, should one develop