How Charcot Foot is related to Diabetes

If you’re among the more than 37 million Americans living with diabetes, you’re probably well aware of the many health complications related to poor blood sugar control and diabetes management. These include a higher risk for developing cardiovascular disease, kidney disease, vision problems, and neuropathy (diabetes-related nerve damage).

This last one – diabetic neuropathy – is why the feet are particularly vulnerable parts of the body for those with uncontrolled diabetes. Prolonged high blood sugar can lead to nerve damage, which can cause numbness and diminished sensation in the feet. This makes it harder for people to feel simple injuries, such as cuts, abrasions, and blisters. When these injuries go undetected, they also go untreated, which makes them more prone to infection and other serious problems.

There’s one foot condition that is fortunately uncommon, but certainly worth understanding for anyone who is living with diabetes. It’s called Charcot Foot or Charcot Arthropathy and it is directly related to diabetic neuropathy.

What is Charcot Foot?

Charcot Foot is a rare but very serious condition that impacts the bone, joints and soft tissue of the foot or ankle. The bones become weak to the point that they break. Joints in the foot or ankle can become compromised causing them to dislocate and, eventually, collapse leading to major deformities in the foot. Because the foot becomes misshapen, it can lead to “pressure sores” that are at a high risk for infection. If left untreated, amputation of the foot may even be necessary.

Diabetic neuropathy and Charcot Foot

Charcot Foot develops in individuals who suffer from neuropathy, one of the major risks for those with diabetes, particularly the Type 2 form of the disease. The lack of feeling associated with diabetic neuropathy can render someone suffering a break or sprain in the ankle unable to sense the pain that is normally associated with such a severe injury. Therefore, the injury goes untreated which can lead to deformities associated with Charcot Foot.

There are no specific causes of Charcot’s foot other than neuropathy. It is, however, usually triggered by an injury, such as a break or sprain mentioned above. It can also be caused by a sore that’s left open and doesn’t heal properly or becomes infected.

The real danger is not knowing.

The frightening part about Charcot’s Foot is that many people are unable to sense there’s any problem until it’s too late. Quite simply, they don’t feel the discomfort they should be feeling and, therefore, continue to walk on the foot, further damaging it and exacerbating the problem. In fact, only about 25% to 50% of all patients who get diagnosed with Charcot Foot report that they recall a specific foot or ankle injury that may have led to the condition.

This is why it is so important for those with diabetes to regularly examine their feet. Not only is this the best way to spot sores and blisters, but it can also be the key to noticing the early signs of Charcot Foot. These include:

– Reddish feet

– Feet that feel warm to the touch

– Unusual swelling in the feet

It can be difficult to know for sure if these symptoms are an indication of Charcot Foot as there are other foot problems that show similar symptoms. But if you are living with diabetes and experience any of these issues, it’s important to see a podiatrist who is familiar with diabetes-related foot conditions.

Complications associated with Charcot Foot

1. The arch in the middle of the foot may drop until it is lower than the heel or toes. This condition is commonly referred to as “rocker bottom” and can be debilitating deformity.

2. The toes on the affected foot may curl inward.

3. The ankle might become unsteady or even twisted out of alignment.

4. Bones may press against the shoes which can lead to open sores that may get infected. The risk of infection is further heightened by poor circulation associated with diabetic neuropathy.

How to reduce the risk of Charcot Foot

Because Charcot Foot is related to diabetic neuropathy, the best thing you can do to avoid it is to prevent the nerve damage associated with prolonged elevated blood sugar. Keep your blood sugar in check with proper blood sugar testing, whether that’s with a glucose meter and test strips or a doctor-prescribed continuous glucose monitoring system, such as the FreeStyle Libre or Dexcom G6. Additionally, always adhere to your doctor-prescribed medication schedule, including insulin injections by syringe or pen, and make smart dietary and lifestyle choices to better manage your diabetes.

It's also important to make self-exams part of your daily routine. Check your feet regularly for blisters or sores that might worsen if left untreated. Look for redness and any changes to the shape of your feet. The sooner you spot Charcot Foot or any diabetes-related foot problems, the better your chances of a positive outcome.

Diagnosing and treating Charcot Foot

Often Charcot Foot is diagnosed through an X-ray. In the earlier stages of the disorder, however, X-rays may not be enough to detect the problem. Many doctors will use MRIs, CT scans, and even bone scans to detect and diagnose Charcot Foot.

In terms of treatment, it all depends on the degree to which the foot is damaged. In many cases, casting or booting the foot can provide the stability necessary for the bones to heal in a stable position. If the damage to the foot is more severe, after casting, a person may be required to wear custom shoes and/or orthotics to accommodate a misshapen foot that no longer feels comfortable in normal shoes. In the most severe cases, surgery may be required to repair intensive breaks and fractures, or if deformities that have developed in the foot make it impossible to walk normally. In a handful of cases, the deformity becomes so untreatable that amputation is the only option.

Again, this is why it’s so important to do everything you can to prevent Charcot Foot and detect it early should it develop. So, don’t shirk those foot exams. Wear proper fitting shoes and moisture-wicking socks to avoid blisters and sores. Diabetic socks that are specially designed to improve blood flow and keep feet dry and free from blisters are also worth considering.

The good news is Charcot Foot is not very common. But it’s even less likely in someone who maintains proper blood sugar control and a solid diabetes foot care program. If you have further questions or concerns about Charcot Foot, it’s a good idea to speak with your diabetes physician.

 

We hope you found this post informative and insightful. At Diabetic Warehouse, we’re committed to helping those with diabetes manage blood sugar with a complete selection of testing and treatment supplies at prices up to 65% less than those found at most pharmacies and suppliers.

Diabetic Warehouse is a trusted supplier of diabetes care products and accessories. For more information and to explore a complete range of products, including glucose meters and test strips, insulin syringes, pen needles, continuous glucose monitoring systems, and more, visit www.diabeticwarehouse.org.