Diabetes affects the feet due to two pathologies, neuropathy and arteriopathy, which arise as a complication of diabetes – explains Dr. Giacomo Clerici, head of the Centre for Diabetic Foot Therapy and the department for prevention of amputations at Humanitas Gavazzeni Bergamo. The neuropathy is responsible for reduced sensitivity and altered foot anatomy, which also cause a change in pace. In diabetic patients suffering from neuropathy, ulcerations may appear on the foot soles. On the other hand, if the patient is affected by arteriopathy, ulcerations may be present on the entire foot surface, and not only on the soles, because of a reduction in blood flow to the foot due to obstructions or stenosis of the arteries that go to the lower limbs. In this case, the cause of ulcerations is ischemic. Before the formation of the ulcer, usually but not always, the diabetic patient may experience tingling in the lower limbs in case of neuropathy, while symptoms of calf pain, especially while walking are experienced in case of arteriopathy. Moreover, it is not uncommon to discover cases in which there are no symptoms. For this reason, the diabetic patient with neuropathy or arteriopathy should check the skin of the feet every day to verify that there are no injuries, maintain feet care from hygiene to pedicure by cutting nails and eliminating calli, as well as using shoes or specific orthotics for diabetics and remembering to be checked after a few months in a specific center.
