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.
Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.
Treatment depends on the exact type of
foot problem. Surgery may be required for some cases.
Gangrene (dry gangrene) is tissue death
due to absence of blood circulation. It can be life-threatening if bacterial
infection develops (wet gangrene).
Many diabetes-related foot problems can
be prevented by good control of blood sugar levels combined with appropriate
care of the feet.
How can diabetes cause foot problems?
Both type 1 and type 2 diabetes cause damage to blood vessels and peripheral
nerves that can result in problems in the legs and feet. Two main conditions,
1) peripheral artery disease (PAD), and 2) peripheral neuropathy are responsible for
the increased risk of foot problems in people with diabetes.
Peripheral artery disease (PAD),
sometimes referred to as peripheral vascular disease (PVD), means that there is
narrowing or occlusion by atherosclerotic plaques of arteries outside of the
heart and brain. Diabetes is a known risk factor for developing peripheral
artery disease. In addition
to pain in the calves during exercise (intermittent claudication), the signs and
symptoms of peripheral artery disease relate to a decreased delivery of oxygen to the lower legs and
feet. In severe cases, the lack of oxygen delivery to tissues can result in
ulcers and even gangrene (tissue death).
Peripheral neuropathy refers to damage
to the peripheral nerves directly as a result of diabetes. Symptoms of
peripheral neuropathy include decreased sensation in the nerves of the legs and
feet, making it difficult to perceive injuries due to lack of feeling. It can
also cause the muscles of the feet to work improperly, leading to misalignment
of the foot that can put pressure on certain areas of the foot.