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**Closure of my websites askdrray.com and nethealthbook.com**

These websites will be taken down on **April 30, 2025** and no further updates will be provided.
I hope you enjoyed the content of these websites. You can continue to read Dr. Schilling’s blogs which I publish daily on Quora

My home page there is: ** https://www.quora.com/profile/Ray-Schilling**

Click on this: Under my image there is a heading “Profile”. Right underneath this you find a search box entitled “search content”. Type in any term you are interested in. You will get several answers I have written (I have written more than 15,000 answers).

On Quora you can also write comments that I will answer.

Thank you for your trust in the past. Ray Schilling, MD
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Effects Of Diabetes On The Feet

Generally speaking, patients with diabetes have a high complication rate with ankle fractures and foot problems. Moreover, diabetes causes peripheral neuropathy, which can lead to numbness in feet.

Given these points, there is a silent change of the vascular supply in both feet, which leads to peripheral vascular disease and wound healing can be more complicated with injuries, fractures or arthritis. For instance, in patients with long standing uncontrolled diabetes the pressure from standing on the feet alone can interfere with normal blood supply and a diabetic foot ulcer may develop.

Neuropathic pain 

For the most part neuropathic pain is more common as the nerves of the legs have undergone severe changes with a lack of feeling and a loss of the normal protective reflexes. Overall this often leads to major foot pain and other problems that are extremely difficult to treat.

Generally speaking with ankle fractures in diabetics there is a complication rate of about 40% whereas a control group with non diabetics had none. The complications ranged from osteomyelitis to chronic diabetic foot ulcers to septicemia. For these reasons treatment in diabetics should be very conservative. The physician would utilize mostly non-operative methods as otherwise below knee amputations have to be done in order to rescue a patient who gets complications from what appeared first to be a minor foot or ankle problem (Ref. 3).

 Effects Of Diabetes On The Feet (Diabetic Foot Ulcer)

Effects Of Diabetes On The Feet (Diabetic Foot Ulcer)

More information about diabetes: https://nethealthbook.com/hormones/diabetes/ 

References

1. ABC of rheumatology, second edition, edited by Michael L. Snaith , M.D., BMJ Books, 1999. Chapter 5.

2. The Merck Manual, 7th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999. Chapter 270.

3. Wheeless’ Textbook of Orthopaedics: http://www.wheelessonline.com/

4. The Merck Manual, 7th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999. Chapter 60, p.487.

5. Goldman: Cecil Textbook of Medicine, 21st ed.(©2000)W.B.Saunders

6. Ferri: Ferri’s Clinical Advisor: Instant Diagnosis and Treatment, 2004 ed., Copyright © 2004 Mosby, Inc.

7. Rakel: Conn’s Current Therapy 2004, 56th ed., Copyright © 2004 Elsevier

Last modified: June 19, 2019

Disclaimer
This outline is only a teaching aid to patients and should stimulate you to ask the right questions when seeing your doctor. However, the responsibility of treatment stays in the hands of your doctor and you.