The Center for Podiatric Care and Sports Medicine

Diabetic Foot Infections: 4 Reasons Diabetics Are Prone

Posted by on Monday, August 10th, 2015


Diabetic foot infections account for 20% of all hospital admissions for diabetics. Patients with foot ulcers wind up paying approximately $4,500 per episode, according to researchers at the New Jersey Medical School in Newark.1 Foot infections are not only an expensive problem in our healthcare system, but one with dangerous implications for patients too. Despite all the scientific advances, it is still extremely difficult to help patients with advanced stages of gangrene injury. Consequently, ulcers are the underlying factor for 85% of diabetic foot amputations.

Current research has found that diabetic patients are most likely to develop foot infections if:

  • They have wounds lasting more than 30 days.
  • They have recurring wounds.
  • They have wounds related to a particularly traumatic event.
  • They have a wound afflicting the bone, such as a fracture.
  • They have peripheral vascular disease.

Compared to the general population, diabetic patients are more likely to suffer from these conditions. Let’s take a closer look at why this is.

diabetic foot
Small cuts and scrapes can cause big problems for diabetics. | Image source: Flickr CC user Caitlinator

1. Trauma often goes unnoticed due to neuropathy.

Uncontrolled diabetes damages nerves in the legs and feet, making you less likely to sense pain, cold, or heat. Obviously, if you break your foot, you’re going to know, whether you have nerve damage or not. Yet, there are many smaller, seemingly inconsequential foot injuries that break open the protective skin barrier and put patients at increased risk for bacterial or fungal contamination. Blisters and cuts related to degrading footwear are extremely common issues that go unnoticed. Ingrown toenails are another problem we see; often, a crushing injury to the nail causes abnormal growth patterns that make the nail dig back into the flesh instead of growing up and out as it’s supposed to. When detected early, podiatrists can treat these minor foot problems easily with debridement and antibiotics. When left to fester, however, more invasive treatments become necessary.

2. Sugar weakens the body and makes it a more favorable climate for microbes.

Microbes favor warm, sugary environments for their colonies. According to Diabetes Monitor, circulating blood glucose can be food for invading germs and also exhausts immune cells, weakening the body and making it more susceptible to infection.2 Diabetics not only suffer from more foot infections, but also ringworm, athlete’s foot, jock itch, vaginal yeast infections, oral thrush, salmonella, listeriosis, and Campylobacterosis infections as well. Shoes, by their very nature, are dark, warm, and rarely washed, which encourages microbe growth. Sweat from the feet’s 250,000 sweat glands also fuels colony expansion.

3. High blood sugar damages blood vessels, resulting in delayed healing.

Medical College of Georgia researchers discovered that elevated blood sugar levels creates low levels of vasodilator nitric oxide in blood vessels — which, in turn, increases blood pressure and narrows blood vessels.3 When blood glucose levels are high for prolonged periods of time, proteins are modified, making the blood vessels unable to relax, and causing chronic hardening in what we call peripheral vascular disease. Damaged blood vessels do not carry as much fresh blood and oxygen to injury sites, which causes delayed wound healing. Blood vessels in the extremities are already relatively small to begin with, so the propensity for non-healing foot wounds increases exponentially with blood vessel damage. Elsewhere in the body, the combination of damaged blood vessels and poor circulation increases the risk of strokes and heart attacks as well.

4. Foot function is altered, causing pressure wounds.

The very anatomy of the foot often changes in diabetics. Muscles begin to malfunction because the nerves that make them work become damaged. When the foot doesn’t align naturally, excessive pressure builds up in certain areas of the feet. Over time, uneven pressure distribution creates skin-thickening injuries like corns and calluses, which easily develop into ulcers. If we catch foot pressure issues early using our state-of-the-art gait analysis technology, we can easily modify a person’s footwear to offload pressure before sores develop.

Diabetic Foot Care in NYC

You may not automatically think of a sports medicine doctor for diabetic foot issues. However, our experienced team of board-certified podiatrists are here for anyone wishing to continue leading an active life. Even if you’re not playing a sport, chances are you still want to go for leisurely strolls, play with grandkids, ride a bicycle, cross-country ski, or do whatever other hobbies make you happy. Our specialists have advanced tools for diabetic foot care at their disposal, including hyperbaric oxygen, pain-zapping lasers, ultrasonic debridement, and more. Even if your blood sugar is controlled by prescription medication, some of these changes in the feet may have already taken place. Don’t wait until trouble starts. Come in for routine foot checkups to detect problems early and have them treated.

Contact us to set up an appointment at our Manhattan or Westchester office.






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If you have any foot problems or pain, contact The Center for Podiatric Care and Sports MedicineDr. Josef J. GeldwertDr. Katherine Lai, Dr. Ryan Minara and Dr. Mariola Rivera have helped thousands of people get back on their feet. Unfortunately, we cannot give diagnoses or treatment advice online. Please make an appointment to see us if you live in the NY metropolitan area or seek out a podiatrist in your area.