How Can Diabetes Affect the Feet?

People with diabetes are prone to foot problems caused by prolonged periods of high blood sugar. There are two main foot problems, each of which can have serious complications.

Diabetes is a disease where the body cannot produce insulin or cannot use it effectively. Insulin is the hormone that is responsible for helping the cells take in sugar to use for energy. When this does not happen properly, the levels of sugar in the blood can become too high.

Prolonged periods of high sugar levels in the blood can wreak havoc on many areas of the body, including the feet.

Diabetic foot problems

Doctor checking a patients feet
Over time, diabetes may cause neuropathy in the feet, which may result in a loss of feeling.

The two main foot problems that affect people with diabetes are:

Diabetic neuropathy

Over time, diabetes can cause nerve damage that makes it hard for people with diabetes to feel sensation in their extremities.

The condition also makes it difficult for a person to feel an irritation on their foot or notice when their shoes are rubbing. This lack of sensation and awareness leads to an increase in the risk of cuts, sores, and blisters developing.

Peripheral vascular disease

Diabetes leads to changes in the blood vessels, including arteries. In peripheral vascular disease, fatty deposits block these vessels beyond the brain and heart. It tends to affect the blood vessels leading to and from the extremities, reducing blood flow to the hands and feet.

Reduced blood flow can lead to pain, infection, and slow healing wounds. Severe infections may lead to amputation.

Symptoms

Symptoms may vary from person to person and may depend on what issues a person is experiencing at the time. Symptoms of diabetic foot problems can include the following:

  • loss of feeling
  • numbness or tingling sensation
  • blisters or other wounds without painful
  • skin discoloration
  • skin temperature changes
  • red streaks
  • wounds with or without drainage
  • painful tingling
  • staining on socks
  • deformed foot appearance

If an infection is present in a foot or foot ulcer, a person may also experience some of the following:

  • fever
  • chills
  • uncontrollable blood sugar
  • shaking
  • shock
  • redness

Anyone who experiences any of the symptoms of an infection should seek emergency treatment.

Complications

Diabetic neuropathy and peripheral vascular disease are serious conditions that must be monitored closely. Both cause complications that can have serious negative effects. These complications may include:

  • foot ulcers, or wounds, that do not heal
  • infections, including skin infections, bone infections, and abscesses
  • gangrene, when an infection causes tissue death
  • foot deformity
  • Charcot’s Foot (fractures or dislocations in the foot that may cause deformities)

When to see a doctor

Swollen left foot
Immediate medical attention should be sought if there are changes to the feet such as skin color, persistent sores, tingling, and swelling of the foot or ankle.

People who have diabetes should see a doctor regularly as part of their care. However, they should seek immediate medical attention if they notice any of the following:

  • changes in foot skin color
  • swelling in the foot or ankle
  • temperature changes in the feet
  • persistent sores on the feet
  • pain or tingling in the feet or ankles
  • ingrown toenails
  • athlete’s foot or other foot fungal infections
  • dry and cracked skin on the heels
  • signs of infection

Treatment

Treatment for diabetic foot problems varies according to the severity of the condition. A range of surgical and nonsurgical options is available.

Nonsurgical treatment

Nonsurgical options are normally the first method of treatment for diabetic foot problems. Some of these include:

  • keeping wounds clean and dressed
  • immobilization devices, such as a cast boot or total contact cast
  • close observation of gangrene toes until self-amputation occurs, when the toes fall off due to lack of blood flow

Surgical treatment

When nonsurgical treatment fails to heal diabetic foot problems, surgery may be considered. Surgical treatment options include:

  • removal of decaying or dead tissue
  • amputation, varying from toe or part of the foot to amputation of the leg below the knee, or above the knee in some cases
  • surgical stabilization of Charcot’s Foot
  • arterial bypass for peripheral vascular disease, or endovascular surgery with placement of stents

Diabetic foot care

lady having a bath
Examining the feet daily and keeping them clean is recommended to prevent diabetic foot problems.

Preventing diabetic foot problems is essential for people who have diabetes. Keeping feet healthy is important, and a person should be vigilant about foot hygiene. They can take the following steps:

  • Check feet each day: Examine the feet daily, or ask someone to check for any changes or injuries.
  • Wash feet daily: Keeping feet clean helps to prevent infections.
  • Wear supportive shoes and socks: It is important to keep feet protected in socks and shoes at all times. A podiatrist may recommend shoes to help prevent deformities. Socks should not be too tight so as to restrict blood flow.
  • Promote blood flow to the feet: Putting feet up when sitting, wiggling toes periodically, and getting enough exercise helps promote healthy blood flow to the feet.
  • Trim nails carefully: Trim toenails straight across and keep them short. Rounded nails can cause ingrown toenails, which can lead to infection.
  • Care for corns and bunions: Treat corns and bunions carefully. Corns should never be shaved as this increases the risk of infection.
  • Protect feet from extreme temperatures: Exposure to hot and cold can damage diabetic feet.
  • Get feet checked regularly: Regular examinations by a doctor are key to preventing infections, amputations, and serious deformities.
  • Control blood sugar: Uncontrolled blood sugar raises the likelihood of podiatric complications from diabetes,
  • Avoid smoking: Smoking adversely affects the blood flow to the tissues.

Preventing diabetic foot problems

Diabetes can cause serious foot problems that can result in loss of the feet or limbs, deformity, and infections. However, many of these problems can be prevented or minimized.

While controlling blood sugar by following the recommended treatment plans is the best way to prevent these serious problems, self-care and regular check-ups with a doctor can prevent diabetic foot problems as well.

Oral Allergy Syndrome: Foods, Symptoms, and Treatments

Oral allergy syndrome is an allergic reaction that specifically affects the mouth, lips, tongue, and throat. It is related to allergic rhinitis, otherwise known as hay fever.

In oral allergy syndrome, the body cross-reacts to certain proteins in specific foods. These proteins are similar to the proteins found in the pollens that are associated with hay fever and seasonal allergies.

As these foods are typically available throughout the year, oral allergy syndrome is not seasonal.

Causes

[hand holding birch emitting pollen]
Many food allergies are, in fact, cross-reactions to allergies caused by pollen.

Proteins are found in all organic matter. The immune system identifies specific proteins in order to target bacteria, viruses, and other unwanted germs. However, it sometimes identifies everyday proteins, such as pollens, as harmful as well.

After being eaten or breathed in, these proteins are available in large numbers and the immune system identifies them as abnormal. The body reacts with a significant immune response, which leads to swelling, various other allergy symptoms, and discomfort.

For many, the key signs of oral allergy syndrome are swelling and itchiness of the lips, mouth, tongue, and throat immediately after eating certain fruits and vegetables, especially when raw.

Experts estimate that more than 60 percent of all food allergies are actually cross-reactions to pollen allergies. The most common cause of allergic rhinitis in the United States is birch pollen. However, multiple trees, grasses, and weeds can cause it as well.

Typically, oral allergy syndrome can be traced back to an allergy to the following:

Trees

  • birch
  • alder
  • Japanese cedar
  • plane

Grasses

  • Timothy
  • orchard grass

Weeds

  • wormwood
  • ragweed
  • mugwort
  • Parietaria species

Common foods that cause oral allergy syndrome

As there is a wide range of potential causes of allergic rhinitis, there is also an extremely varied range of fruits and vegetables that cause oral allergy syndrome.

Similarly, different fruits and vegetables may cause a different response depending on the type of pollen the immune system cross-reacts to. According to a paper in the Journal of Allergy, typical foods that may cause a reaction include:

[woman vehemently refusing nuts]
Nuts such as peanuts and walnuts are common allergens and can cause mild to severe symptoms.

Fruits

  • Prunus genus: cherries, nectarines, peaches, plums, apricots
  • apples and pears
  • mangoes
  • bananas
  • figs
  • avocados
  • strawberries
  • raspberries
  • kiwis
  • watermelons
  • melons
  • oranges

Vegetables

  • Apiaceae family: celery, carrots, parsley, parsnips, cilantro, cumin, dill, chervil, and fennel
  • Nightshades: tomatoes, potatoes, and peppers
  • Cucurbitaceae family: pumpkins, butternut squashes, zucchini, cucumbers
  • lettuce
  • corn
  • artichokes
  • peas

Others

  • hazelnuts and walnuts
  • peanuts
  • chickpeas
  • wheat
  • soy
  • almonds
  • lentils
  • sunflower seeds
  • honey

Symptoms

Symptoms of oral allergy syndrome only occur after eating specific foods. The symptoms vary significantly and can peak at different stages of life.

Mild symptoms include:

  • itching of the throat, mouth, lips, or tongue
  • swelling, particularly of the lips and tongue

More severe symptoms include:

  • swelling of the throat
  • nausea and vomiting

Additional symptoms can include hives and asthma. Typically, hives occur when the food is being peeled, chopped, or grated. Asthma occurs when the food is being blended or otherwise vaporized, such as during stir-frying.

Those who experience more severe symptoms should see their doctor.

Diagnosis

Diagnosing oral allergy syndrome often involves several steps. Typically, these include clinical and laboratory methods.

Clinical

Clinical methods are the most common. Diagnosis requires confirmation of allergic rhinitis along with itching and tingling that develops after eating fresh fruit or vegetables. In many cases, an accurate patient history shows a link between eating a specific type of food and the start of tingling or swelling.

In other cases, the doctor may propose an elimination diet. The person avoids specific food groups that may cause oral allergy syndrome for a set amount of time and records whether it makes a difference.

Laboratory

[a doctor does an allergy test on a patient's arm]
A dermatologist can diagnose allergies by using a prick test and measuring the level of reaction.

Laboratory tests typically involve skin testing via a prick test, a scratch test, or a blood test. For skin testing, a dermatologist marks out a grid on the back or the forearm and applies extracts of pollens, fruits, or vegetables. Any marks that develop on the skin are measured after 15 minutes to determine the level of reaction.

If prick tests with the pollen are positive but the food itself fails to provoke a reaction, the person may be asked to eat a certain amount of the suspected food. A reaction immediately after eating this food will confirm the presence of oral allergy syndrome.

In some cases, blood tests might be used to diagnose the condition. First, the doctor performs a test to work out the total level of antibodies in the blood. Another test then checks for specific antibodies. Blood tests are often used when skin tests are not available or practical.

Treatment and lifestyle tips

There are no standard treatments for oral allergy syndrome other than avoiding specific foods that are associated with allergy symptoms. Careful management of diet can ensure that people with the syndrome can lead otherwise normal lives. People with oral allergy syndrome should explain the condition to others to help them understand what foods are off-limits.

In the event of an allergic reaction, initial treatment generally involves rinsing the mouth with water and then resting. Hot drinks can also destroy some proteins, and so inactivate them.

Antihistamines typically take 1-2 hours to work, while the effects of oral allergy syndrome typically start to wear off after about 30 minutes. However, an antihistamine can prevent effects from lingering and should be taken as soon as the reaction occurs.

In some cases, it may be possible to make the immune system less sensitive to the allergen through immunotherapy or allergy shots. This is especially useful when a single allergen is involved. Under-the-skin delivery of immune therapy is currently being studied as a treatment option for oral allergy syndrome.

Does cooking foods help with oral allergy syndrome?

In some cases, cooking foods can destroy the proteins that cause oral allergy syndrome. However, this depends on the foods that trigger the allergies.

In general, nuts and spices are exceptions to the cooking rule. Nuts contain multiple allergens and not all of them are destroyed by heat. The same applies to celery. Allergens in strawberries are also resistant to heat.

Pasteurized fruit juices are generally okay as they have been heat-treated. However, some smoothies may contain raw, unpasteurized juices or purees. These are best avoided if any of the ingredients are triggers.

However, most foods are made sufficiently safe by cooking. Examples include tomatoes, apples, potatoes, pears, and most soft fruits.

Lifestyle tips

In many cases, avoiding the food completely is the only sure way to prevent the symptoms of oral allergy syndrome. However, there are some methods that people may wish to try so they can enjoy their favorite foods.

Lightly microwaving fruits – particularly apples – for about 1 minute and then chilling them immediately may reduce the effects of oral allergy syndrome to a manageable level. This process can remove the main proteins that cause reactions.

In addition, there is usually plenty of these proteins in the skin, so peeling fruits before consuming them may reduce reactions significantly.

Wearing gloves when peeling fruits can reduce the symptoms of hives. Not stir-frying vegetables can also reduce the risk of asthma.

People with oral allergy syndrome often find that their symptoms worsen during pollen season so they may wish to avoid trigger foods at the peak of that season.

In addition, managing seasonal allergic rhinitis correctly is key to coping with oral allergy syndrome symptoms. This is normally done with antihistamines and a steroid nasal spray 2 weeks before the season is due to start, and then regular use throughout.

What Is Leaky Gut? Causes, Symptoms, and Relief

A leaky gut is characterized by perforations in the intestinal wall that allow molecules or microorganisms to pass through into the bloodstream. The phenomenon is a profound failure of the intestines’ duty to act as a protective barrier. Leaky gut syndrome is difficult to diagnose; many physicians do not know to look for it when diagnosing patients who are experiencing a complicated array of symptoms.

What Exactly Is the Gut?

The gut encompasses the intestinal mucosa (lining), the microbial community (and its genes) in the intestines, and the immune system and nerves. In addition to being the most important organ in the digestive system, the intestines are the largest immune organ, with roughly 2,700 square feet (or 250 meters) of surface area. Eating or drinking exposes this tennis court-sized area to the outside world. The digested molecules (micro-, macro-, and phytonutrients) in food are supposed to filter through the intestinal mucosa, which is made up of the epithelial cells on the surface of the small intestine. The contents of the intestines are supposed to remain in the intestinal lumen and continue the journey to the colon. But, with a leaky gut, the contents of the intestine can slip, unregulated, between the epithelial cells of the intestine.

The spaces between the intestinal cells, known as tight junctions, are supposed to form a seal between the inside of the intestinal lumen and the rest of the body. When the tight junctions aren’t tight enough, things slip past the intestinal gatekeepers and into the bloodstream. From here pathogens, toxins, and antigens can circulate throughout the body, wreaking havoc and provoking a systemic inflammatory response. The loose gaps between the cells in the intestinal mucosa are associated with a myriad of conditions and syndromes including:

  • Inflammatory bowel disease (IBD)
  • Irritable bowel syndrome (IBS)
  • Type 1 diabetes
  • Rheumatoid arthritis (RA)
  • Food allergies
  • Celiac disease
  • Asthma
  • Autism
  • Parkinson’s

What Causes Leaky Gut?

The tight junctions are not a perfect barrier. A number of factors can cause them to relax or contract—diet, medication, hormones, inflammation, and more. When the tight junctions relax or contract, their function may be disrupted.

1. Diet

Few things affect health as much as diet. Several primary offenders appear to contribute to the development of leaky gut:

  • Alcohol: When the human body metabolizes alcohol, the metabolic product acetaldehyde can increase intestinal permeability.
  • Sugar: Sugar and artificial sweeteners cause inflammation that compromises gut health. Additionally, a urine analysis that measures glucose in the urine is a useful indicator of the severity of leaky gut.
  • Dairy: Dairy products are linked to gastrointestinal disorders—–particularly among individuals on the autism spectrum.
  • Gluten: Consumption of gluten contributes to increased intestinal permeability in those with gluten sensitivity.
  • Additives: Industrial food additives such as emulsifiers, solvents, microbial transglutaminase, glucose, and salt contribute to leaky gut syndrome.
  • Pesticides: Glyphosate disrupts gut bacteria, which can contribute to the development of intestinal permeability.

    2. Candida

    Several species of candida are known to disrupt the makeup of the gut microbiota. The resulting imbalance in the microbiota is called dysbiosis. These disturbances can lead to the development of digestive disorders including leaky gut.

    3. Chronic Stress

    It’s no secret that stress negatively affects your health but it’s especially taxing on gut health. Psychological stress increases the presence of inflammatory cytokines, a class of signaling proteins created by the immune system that contributes to the development of leaky gut. Animal studies have shown that both psychological and physical stress compromise the integrity of the intestinal barrier.

    4. Environmental Toxins

    The environment is flooded with harmful chemicals and substances, many of which pose a significant risk to your health. Mercury, BPA, fungicides, and insecticides can all negatively affect intestinal permeability.

    5. Medications

    Non-steroidal anti-inflammatory drugs (NSAIDs), such as aspirin, ibuprofen, and naproxen have demonstrated a tendency to increase intestinal permeability and provoke inflammation.

    6. Zinc Deficiency

    Zinc is an essential trace mineral that supports the immune system and plays a significant role in irritable bowel diseases. Zinc deficiency can lead to intestinal permeability, while supplementation with zinc supports the function of the tight junctions.

    Symptoms of Leaky Gut Syndrome

    You might think the symptoms of leaky gut are all digestive disorders but, because leaky gut allows foreign bodies to enter the bloodstream, it can exert a wide range of effects the body as a whole and produce a varied array of symptoms. Some of the more obvious symptoms include allergies, cardiovascular disturbances, and a multitude of metabolic disruptions. Chronic fatigue syndrome and depression are separate and unique conditions, but both are known to result from compromised integrity of the intestinal mucosa.

    Intestinal permeability allows foreign microbes access directly to the bloodstream. In response, the immune system releases antibodies, which mistakenly attach to normal proteins in the blood, tagging them for immune action. Fortunately, there are ways to ease the burden of living with a leaky gut.

    What’s the Best Solution for Leaky Gut?

    Following a healthy diet is one of the most effective measures to help manage leaky gut. Foods that are a source of probiotics are helpful for mitigating the effects of the disorder. Nutrients like glutamine and curcumin support the intestinal environment by balancing the overstimulated immune response and the oxidative stress that weakens the intestinal wall.

    Monitoring what goes into your body is one of the best natural remedies for managing leaky gut. If you suffer from a digestive disorder, whether it’s leaky gut, irritable bowel syndrome, celiac disease, Crohn’s disease, or any of the many disorders associated with hyperpermeability, try keeping a daily food journal to identify the foods that trigger symptoms. If you experience frequent flare-ups, it’s time to make significant lifestyle changes such as incorporating the best foods for leaky gut into your diet to support your health and quality of life.