Barefoot or Shoes?

Running barefoot may seem odd and even dangerous, but a new study published in the prestigious Journal of American Academy of Physical Medicine and Rehabilitation found that barefoot running puts less damaging torque on our hip, knee, and ankle joints than wearing supportive running shoes.

The study was written by D. Cassy Kerrigan, M.D. et al and titled: The Effect of Running Shoes on Lower Extremity Joint Torques.” The researchers compared barefoot to shoe running and found a remarkable 54% increase in the hip torque and 38% in knee varus torque in running shoes. The study used the most technologically advanced non-invasive techniques to asses the biomechanics of running.

For thousands of years Man ran without supportive footwear. It is only in the last few decades that some people, mostly shoe companies, told us our feet needed support, control, and stability. This research shows a huge reduction in joint torques on the main weight-bearing joints of our lower extremities. Could the barefoot runner have been on to something?

Interestingly, I have not found one published study showing any detrimental effects to running without shoes or in just minimalist footwear.

The paper says, there is no clinical evidence to support that  modern running footwear promoted long-term health in runners. That line is worth reading again!

The running shoe business is huge and yet none of these billion dollar companies can provide ANY clinical evidence that running shoes promote long-term health!

And now this paper supports less torque on runners’ joints when they wear nothing—just running barefoot. Who would’ve thunk it?!

To be clear, Dr. Kerrigan’s study found that the effect of the typical modern-day running shoes is to increase joint torques at the hip, knee, and ankle. This doesn’t mean every running shoe will increase torque, but given the huge difference in torque between barefoot and shod, it is reasonable to expect that just about every shoe will have some increase in joint torque over going barefoot.

The good news is that Kerrigan’s study advocates that running shoes should encourage or mimic the foot’s natural function. Thankfully, she is in the shoe design business! This is what the shoe industry needs—someone who backs up their work with sound research. It is time runners demand clinical evidence a shoe works; not million-dollar ads!

I am sure the shoe, insole and arch support lovers (and business people), will find ways to discredit this research or try to simply dismiss it.

These studies are rarely perfect and ultimately, just because there is more torque, does that mean there will be more injury or damage to the joints? The answer is obvious–of course! But, this study hasn’t proven that. To show actual damage to a joint, a long-term study would need to be done with MRIs or CAT Scans or some such technology. Regardless, this study is a huge first step, and all the hole-poking in the world will not negate the magnitude of this study’s findings.

Final Thoughts on Proof Running Shoes Increase Torque on Our Joints

This study is but one. I hope that more scientists will begin to investigate the effects of running with shoes or barefoot. It is time for a rational discussion on the proven benefits and hazards of running in hundred and eighty dollar trainers or just your bare skin.

References:

Science Daily

Better Health Research

Telegraph

Medical News Today

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When most of us think of the color of our shoes, we think about which outfit or pair of pants we’re going to wear with them. However, the color of your shoes can affect your feet.

The Science of Shoe Color and Foot Temperature

In one study, researchers compared the temperature of water in a balloon inside white-colored shoes verses black-colored shoes. After 30 minutes, the water temperature rose in both the white and black-colored shoes, but the water inside the black shoes showed a mean increase beyond the temperature of the white by 7.8 to 13.6 degrees Fahrenheit.

The researchers deemed the increase in temperature in the black-colored shoes (over the white shoes) “significant” (DeLuca and Goforth, 1998). I agree–a 7.8 to 13.6 increase in temperature IS SIGNIFICANT, and this is a shoe without an active, moving, perhaps sweaty, foot inside!

These researchers presented two cases where people with insensate feet (due to neuropathy associated with diabetes) sustained burns because of wearing black-colored footwear on a hot day. These two diabetic patients (with neuropathy) ended up needing foot amputations.

Shoe Color Can Affect All Our Feet — Not Just Those of Diabetics

Even if you are not diabetic, the effect of a shoe color (black) that increases the temperature of your feet can be a problem. When the temperature in your shoes increases, blood vessels in the foot dilate as blood leaves your arterioles and enters veins. This process promotes the release of heat out of the foot, but causes the foot to swell (Henry and Gaucer, 1950).

Normally, muscles pump swelling in the feet out, particularly during walking. However, even vigorous walking has been shown to not to be able to reduce venous pressure (pressure in our veins due to swelling).

Worse, for a foot wearing a dark-colored shoe, our foot muscles themselves generate heat. Muscles in our legs dissipate half their heat directly to the surrounding environment (Gonzalez et al, 1999). By extrapolation, our foot muscles likely release half their metabolic heat into the shoe, further increasing the temperature. Again, this increased heat could worsen swelling (edema).

Swelling or edema of feet can lead to poor perfusion of blood to the tissues, constriction, varicose veins, joint stiffness, diminished function, and symptoms of pain, heaviness, cramping, and restlessness (Blattler et al, 2008).

Today, more than 10 years after DeLuca’s study, the Medicare diabetic shoe program continues to approve dark-colored (and black-colored) shoes for diabetics, and shoe and running shoe companies continue to manufacture dark-colored shoes.

One has to wonder how many people are having more swelling and in the case of diabetics, foot sores and even amputations, due to the dark-colored shoes.

Final Thoughts on the Effect of Shoe Color on Your Feet

Few people would wear a black shirt on a hot summer day, but these same people would not think much of slipping on black-colored shoes. It is common sense that darker-colored material will absorb more heat than lighter-colored material. The next time you buy a shoe, use your common sense and buy a light-colored shoe. Your feet will thank you!

References:

DeLuca PA, Goforth WP. Effect of shoe color on shoe temperature and potential solar injury to the insensate foot. J Am Podiatr Med Assoc. 1998 Jul;88(7):344-8.

González-Alonso J, Calbet JA, Nielsen B.  Metabolic and thermodynamic responses to dehydration-induced reductions in muscle blood flow in exercising humans. J Physiol. 1999 Oct 15;520 Pt 2:577-89.

Henry JP, Gauer OH.  The influence of temperature upon venous pressure in the foot.  J Clin Invest. 1950 Jul;29(7):855-61.

Hansen L, Winkel J, Jørgensen K. Significance of mat and shoe softness during prolonged work in upright position: based on measurements of low back muscle EMG, foot volume changes, discomfort and ground force reactions. Appl Ergon. 1998;29(3):217-24.

Blättler W, Kreis N, Lun B, Winiger J, Amsler F. Leg symptoms of healthy people and their treatment with compression hosiery. Phlebology. 2008;23(5):214-21.

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MRSA - A microbe that can cause serious foot infections

When we get a foot or toe infection, whether a simple infected, ingrown toenail or perhaps life-threatening pneumonia, it is due to tiny organisms, often called “bugs” or “germs.” 

The only way to see these bugs is with a microscope.  Scientists have categorized these bugs into different categories: bacteria, viruses, and fungus.

Within the bacteria category there are “good” and “bad” bacteria.  One of the more common infection-causing bacteria is Staphylococcus aureus, often called S. Aureus or just “Staph.”  The bug can be harmless or it can cause infections—minor or lethal.  The good news is that most strains of S. Aureus can be killed by antibiotics. The bad news is that there is a strain of Staph that is difficult to kill: MRSA. 

A True Superbug 

Pronounced “mursa,” methicillin-resistant staphylococcus aureus (MRSA) is one of the worst infections imaginable—a true “superbug.”  But, there is nothing super about it.  It can be just about anywhere: on clothing, countertops, floors, carpets, the health club yoga mat, even the high school football; and MRSA doesn’t discriminate.  It has killed the elderly, babies, toddlers, teenagers and even healthy, strong athletes.  Recently, MRSA has been responsible for closing public schools.

There are different strains of MRSA.  There is hospital-acquired MRSA and community-acquired MRSA. Most people die from hospital-acquired MRSA. 

The Staph organism is all around us.  Worldwide, 2 billion people have the Staph organism on them—on their skin, in their nose, even in their lungs—and don’t know it.  It is estimated that 57 million (2.7%) of these people have the MRSA strain of Staph.  People can carry the bug for years without any symptoms.  Usually, these people have strong immune systems.  But, even with strong immune systems, the bug can flare up at anytime or these people can spread the bug to someone else.

According to the Journal of the American Medical Association, in 2007, MRSA will infect 94,000 people and of those, 19,000 will die, and those numbers are rising.  In 2005, the Centers for Disease Control counted more deaths from MRSA than AIDS (HIV).

Our Feet Are At Risk

One of the most common places these bugs, such as MRSA, can attach themselves to us and enter our bodies is through our foot or toes. These infections can start very innocently, perhaps with a simple ingrown toenail, a cut or a nick on your heel or foot. 

You might pick up these foot infection-causing bugs while walking across the locker room floor, around a swimming pool, or even on your back porch.  Basic wound care and antibiotics control most foot infections, but not all. 

Some people’s feet are more at risk. Those people with diabetes or poor circulation have a higher foot infection risk.

As a practicing podiatrist, I see serious infections in the foot routinely.  MRSA causes the worst of these foot infections.  It is so virulent that it can actually burrow into the bones of the foot and destroy them.  In other cases, it can cause gangrene and result in amputation of a toe or foot, or even death.

In rare circumstances, patients die from MRSA.  I have had to perform life-saving emergency amputations to save lives.  Sadly, of those who survive MRSA, many are left disfigured—be it from scars or amputations of a toe, foot, leg or even a finger, hand or arm.

12 Simple Steps to Prevent a Foot or Toe Infection

What follows are 12 magic, simple steps to protect you and your family’s feet from infection, particularly MRSA. Preventing foot infections is easy once you know what to do.   

1. Wash Your Hands  — Don’t Spread germs to your feet or toes! 

Infections and MRSA can live on clothing, countertops, or just about anywhere.  Our hands are our number one way we pick up infection-causing bugs.  Wash your hands frequently, and especially before you touch your eyes, ears, nose, mouth or feet.  To kill germs, you don’t need fancy antibacterial soaps, just good old fashioned soap and warm water.  Wash your hands vigorously for at least 20 seconds and then dry them with paper towel. 

2.  Check Your Feet Daily  — Catch foot problems early! 

It’s amazing how many people don’t look at their feet, or if they do see a problem or have pain, they shove their foot into a shoe and try to forget about it.  Infections often start as a small red bump or swelling.  It may look like a bug bite or an ingrown hair.  There may not be any pain, but that doesn’t mean that a serious infection or other foot problem isn’t starting. 

When examining your feet, be sure to check between the toes, as this is a common area for infections to start.  Also, watch for any blisters, cuts, or open sores.  Toenails that become ingrown are prone to infection; see a podiatrist immediately. 

If you have trouble bending over to see the bottom of your feet or heels, have someone check your feet for you or use a mirror to see underneath (read my review of a fantastic scale with built in foot mirror).

Persons with diabetes or poor circulation need to be especially vigilant about checking their feet.

Parents need to check their children’s feet until their kids are old enough to do it themselves.  Children must be educated on the risks of foot infections and encouraged to let their parents know when a problem is starting.  Surprisingly, many times in my podiatry practice, a parent will bring a child in with a severely infected foot, telling me they just noticed it; however, when I question the child, I learn it started months ago. 

There are several reasons children don’t tell their parents about foot infections or other foot problems, such as embarrassment, fear of having to go to the doctor or fear they will not be allowed to participate in a certain activity, such as a favorite sport.  The main reason is, however, they just don’t think the infection is a problem.

3.  Be Careful How You Use Your Towel around Your Feet 

Towels are a breeding ground for bacteria and scientists have recently proven that towels have spread infection and MRSA to your feet.  As a result, it’s important not to share your towel with others.  If you wipe down equipment at the health club, do not use the same towel on your body or face.  The same applies to a towel that you’ve used on your feet; don’t use it on the rest of your body or face.

Once a towel has touched the floor, whether in a locker room or the home bathroom, consider it infected.  Never reuse a damp towels that has been in your gym bag, unless you wash it thoroughly first with hot water and soap.  At home, bacteria can breed quickly in damp, dirty towels, so be sure to wash them often.  When washing towels, the water temperature should be a minimum of 40 degrees if you are using bleach or at least 60 degrees without bleach.   

4.  Wash Your Feet Everyday 

Some people think standing in the shower is washing their feet.  That isn’t enough.  In fact, that could make matters worse.  If warm, dirty water pools in the bottom of the shower it could breed more bacteria and lead to an infection in your foot.  Feet need to be lathered with soap and scrubbed with a good brush or a loofah. (Again, this tip is very important for persons with diabetes or poor circulation).

5.  Keep Your Feet and Toes Dry 

After washing your feet, be sure to dry them well, especially between the toes.  Moisture, especially between the toes, is a breeding ground for bacteria.  To prevent moisture from accumulating, put a little foot powder, talcum or cornstarch between your toes. 

6.  Wear the Right Socks on Your Feet

You need to wear socks that wick the moisture away from the skin of the feet and toes.  Moisture acts as breeding ground for bacteria and fungus. 

Sock technology is quite sophisticated these days and many athletic socks wick moisture away from the skin quite effectively.  Do not wear 100% cotton socks.  Cotton offers good cushioning for your feet, but allows moisture to build up, creating a breeding ground for bacteria.  Cotton-blend socks tend to be better, or wear a wool sock. 

It’s important that your socks should fit correctly.  Socks that are too big will bunch up under the toes and create friction and abrasions, possibly causing breaks in the skin that bacteria might enter.  Socks that are too small can constrict the circulation to the toes and cause the toes to become bent and contracted, leading to friction, blisters and potential infections.  

7. Don’t Go Barefoot In Infection-Prone Environments 

Bacteria love breeding in damp areas, such as saunas, showers, bathrooms, and locker rooms.  To prevent infections from entering your feet wear sandals or flip-flops–do not walk barefoot.

Keep in mind, that sandals or flip-flops themselves can quickly rife with infectious-causing bacteria if not cared for properly.  Storing damp flip-flops or sandals in a dark gym bag, particularly with sweaty clothes, could make them more dangerous than the locker room floor.

Always, dry your flip-flops and sandals thoroughly before putting them away.  The best way to dry flip-flops and sandals is to set them in direct sunlight.  When that isn’t possible, dry them with paper towel and wash your hands afterwards.  A good additional step is to spray your flip-flops once a day with an antibacterial spray, such as Lysol. Be sure to let the Lysol dry before you wear them.

Whether at home or the health club, I recommend you have two pairs of sandals.  This way you can let one pair air out each day, and always be wearing a dry, clean pair.    

8. Go Barefoot When Not In an Infection-Prone or Dangerous Environments

There are few safe places to go barefoot.  But, the more you can air out your feet, toes and heels, the better.  Bacteria like moist, dark areas, and shoes and socks create the perfect breeding ground around your feet.  At night in bed is a good time to let the air at them.    

9. Take Care of Your Shoes

Shoes and particularly athletic shoes can be loaded with infection causing bacteria, fungus, and yeasts.  In fact, old running shoes often have 100 times more yeasts and molds than a recently flushed toilet bowl. The best way to kill germs in your shoes is with the SteriShoe UV Sanitizer. 

Like flip-flops, air out your shoes everyday and spray the insides with an anti-bacterial spray, such as Lysol, and have two pairs so you alternate wearing them each day.  If the insole is removable, spray underneath it.  Some shoes have washable insoles, and in those cases, wash the insole regularly.

Try to buy shoes comprised of breathable materials.  Avoid shoes that contribute to moisture build up, such as shoes made of certain kinds of plastic. 

Also, be sure your shoes fit correctly.  Tight-fitting shoes can crunch up the toes leading to abrasions and potential areas of infection.  Loose shoes allow the foot to slide, possibly causing friction areas and blisters that can let bacteria enter the feet.  Parents need to check their child’s shoe fit frequently; kids don’t always tell mom and dad when they’ve outgrown their shoes and they are becoming too tight.   

10. Take Care of Your Toenails

You should cut your toenails regularly and straight across.  Do not round the nails at the corners.  On the big toe, you should leave a tiny bit of nail protruding to help prevent ingrown toenails.  The toenails on the big toe tend to get infected more often than the other toessnails. Be careful not to cut nails too short or they become ingrown and possibly infected. 

After cutting your nails, use a nail a file to smooth rough edges.  Leaving a jagged edge can cause the nail to catch on your sock and become split or cracked, creating an area for infection to set in.  It is a good idea to use a nailbrush to remove debris that accumulates under the toenails. 

If you go for pedicures, make sure the salon adequately sterilizes their instruments.  Improper disinfection of salon whirlpools and instruments have spread infections. (Read my article on having a Safe Pedicure).

11.  Take Care of Your Skin of Your Feet

The skin on your feet should feel smooth.  Dry, calloused skin can crack and fissure, allowing infectious-causing bugs to enter. Use hydrating creams and lotions on dry, calloused skin.  The most common places for dry, calloused skin is around the heels and balls of the feet. 

 12.   Seek Help Promptly for Foot Problems

Foot infections or other foot problems can be more serious than they appear.  Sometimes, diabetics, due the sensation in their foot diminishing, can develop an open wound and infection, and not feel any pain.  Because it doesn’t hurt, these diabetics oftentimes they believe it isn’t serious and let infections fester too long before seeking medical care. 

Occasionally, patients will try to treat their foot problem or infection themselves.  As a podiatrist, I see the cases where these home remedies did not work.  Many of these patients went on to lose their toes, feet, or legs.  Most of these amputations were preventable, if the patients had sought medical treatment sooner. 

The bottom line is: when you see a foot problem or infection, immediately seek medical care from a podiatrist or other qualified physician.

Conclusion: Foot and Toe Infections in the Feet Are Preventable and Treatable

Now you have the 12 magic tools to help prevent MRSA and other infections in the feet.  Use them.  Pass them along to your friends and family–especially if they are diabetic, prone to foot problems or have poor circulation.  Infection-causing germs, such as MRSA, does not hyave to cause gangrene or amputation! 

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Feet talk. Of course, they don’t rattle on like some annoying relative. They do often mirror overall health, at times being the first place to show signs of serious medical problems.

Is That Pain in the Foot a Tumor in the Neck?

For example, when a 41-year-old man came to my office with pain and swelling in his foot, he thought he had injured himself playing baseball; instead, we discovered a tumor in his neck. The tumor was altering chemicals in his body. One of these, uric acid, was so severely elevated that it couldn’t be contained in his bloodstream and entered several joints in his foot, causing his pain. The patient had the tumor removed, and a month later his foot pain disappeared. This case was especially rewarding because had this tumor not been caught, it could have affected his heart, possibly becoming fatal. (Read more about it HERE).

Most instances of feet revealing medical conditions are not this dramatic, but many systemic problems often show up in our feet first.

Nailing Down Nails

Let’s start with our toenails. Nowadays, with MRIs, CT scans, and hundreds of blood tests to choose from, few doctors look at toenails. Sadly, some don’t even give feet a cursory glance. But in ancient times, examining the toenails was as important as having patients stick out their tongue.

A small change in our toenails’ color, shape and pliability may be the only indication of a more serious medical problem. Toenails that become rounded or “clubbed” may mean the person has lung cancer, emphysema, liver disease or a heart problem.

Brittle nails could signal poor circulation, an iron deficiency or a kidney or thyroid problem. Short, small nail beds may be a sign of heart disease, and grey nails may mean the person has glaucoma.

Don’t Forget Your Vitamins

If you’re not eating your vegetables, toenails can reveal that too. A spoon-like or flat nail could mean a lack of certain B vitamins. Splitting and fraying of toenails may signal a need for folic acid or vitamin C. Small white patches on toenails could signal a zinc deficiency. (Read more about vitamins and our feet HERE).

Is That Redness on Your Foot an STD?

A rash or redness on the feet could be a sign of infection, a circulation problem or a sexually transmitted disease. That’s right, STDs—in my practice, I’ve seen signs of AIDS, herpes, syphilis and gonorrhea show up in the foot.

People are usually surprised to hear about sexual diseases in the foot. But when feet, oftentimes the big toe, get involved in sexual activity they are just as susceptible as any other body part to infectious diseases. Some diseases, like AIDS, cause growths and other skin changes on the feet, and others, like herpes, spread to the feet when the person removes their underwear.

Are your feet swelling up? When only one foot swells, it often signals a problem within the foot itself, such as infection or a fracture. It might also be due to a blood clot or a circulation problem. If both feet swell, it could mean you have heart, kidney or liver failure.

Is it just Dry Skin or Something More?

The skin of our feet tells us a lot, too. Dry skin may be a sign of an under-active thyroid, diabetes, poor circulation or malnutrition. Sweaty skin could mean an overactive thyroid, menopause, anxiety or a psychiatric disorder.

Bone deformities, such as heel spurs or bunions, may be a clue that the person has certain types of arthritis. Your doctor should check for these, as many arthritic diseases can affect the entire body, including the heart.      

Final Thoughts on Reading Your Feet

So, feet can reveal quite a lot of information about a person’s overall health, even when the condition has nothing to do with feet. On the lighter side, feet reveal plenty about a person’s personality as well. People love to adorn their feet with toe rings, ankle bracelets and even tattoos.

The most interesting tattoo I’ve seen was a trail of black ants on a young man that began at his big toe and went up his leg, apparently to his groin—I didn’t check.

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Most people don’t think much about their feet, let alone take time to look at them. But, nearly everyone cares about their weight.

Now, a remarkable new scale—the Insight Foot Care scale—facilitates daily foot exams when you weigh yourself.

Still, most people are probably wondering why they should check their feet daily. One word: melanoma. This disease can affect anyone and can lead to a foot amputation and even death. 

Before we discuss melanoma, let’s talk about the main reason for the Insight Foot Care scale—prevention of diabetic foot amputations.

For diabetics, the smallest sore, blister, or infection can quickly accelerate to a severe problem or gangrene, and quickly lead to the need for amputation of a toe, the foot, or even the leg.

Studies show that one in five diabetics will endure an amputation. Sadly, most of these amputations are preventable, if caught early.

Diabetes often causes decreased sensation in the nerves of feet and as a result, people with diabetes may not feel a sore or infection on the bottom of their foot.

Many diabetics often don’t realize they have an infection or sore on their foot until they try to remove their sock and it sticks the foot (from pus).

In fact, I have had diabetic patients come to see me for sores on the bottom of their feet and when I take an x-ray, I discover a needle or other sharp object inside the foot. Because these patients have decreased sensation, they usually don’t have any pain, and as a result, are surprised to learn they stepped on a needle or other sharp object.

Loss of sensation in diabetic feet is often due neuropathy, which literally means, “a disease of the nerves.” Neuropathy is nothing to get nervous about, but you do need to take it seriously.

Neuropathy affects millions of people each year, and though diabetics are most affected, it also occurs in people with thyroid problems, vitamin deficiencies, alcoholism, and some types of arthritis, and as a possible side-effect of chemotherapy treatment.   

Anyone with neuropathy (lacking normal sensation in the feet) is at higher risk for recognizing serious foot problems too late.

Healthy people, without diabetes, can feel pain and this is the body’s way of alerting us that there is a problem. But, without that pain sensation the only way to catch a problem is to see it—that is why diabetics or those people without normal sensation must check their feet daily. In a moment, I will explain how the Insight Foot Scale makes checking your foot easy.

First, let us return to melanoma, a deadly disease that can affect anyone.

Melanoma is a cancer that often starts as a small mole, lesion, or freckle.

When melanoma occurs on the foot it is usually not caught until it is too late, often resulting in the loss of the foot or leg, and even death. Each year more than 8,000 people die from melanoma—nearly one death every hour.

Fortunately, when caught early, most people with melanoma survive.

Melanoma does not discriminate. It occurs in the young and old, in African-Americans and in Caucasians, and in males and females. Though, Caucasians or fairer-skinned people are at higher risk.

Any suspicious moles, lesions, or freckles on your foot could be melanoma and a podiatrist should evaluate these. The Insight Foot Care scale makes checking for melanoma on the bottom of the foot easy.

The Insight Foot Care scale makes examining your feet not only easy, but also fun.

The scale arrived in a well-padded box and came with detailed, easy to follow instructions.

Since my partner in practice with me at Friendly Foot Care, Dr. Michael Lacey, is a type 1 diabetic, I asked him to help me test the Insight Foot Care scale.

The scale appears to be well built and sturdy. Certainly, able to withstand being stepped on repeatedly by some of the populations heavier people.

The scale’s has a modern, sleek design ensures it would never be an eyesore in even the most luxurious of bathrooms. As far weighing yourself, the numbers are large and easy to read.

The real innovation of the scale is its two illuminated tilted mirrors that magnify the bottom of your feet. These mirrors allow you to observe every detail of the bottom of your feet each day your weigh yourself.

Dr. Lacey and I found the Insight Foot Care scale easy to use, fun, and most importantly it succeeds in doing what it advertises: allows great visualization of the bottom of your feet.

In summary, I believe everyone should have (and use!) this scale, especially if you are diabetic or have neuropathy. 

I give the Insight Foot Care scale 5 Toes Up!

Link: Insight Foot Care scale 

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Nearly 24 million Americans have diabetes and according to the American Diabetes Association in 2004 about 71,000 lower limb amputations were done on diabetics. Within 5 years, nearly half of these people will die.

In 2008, the Journal of the American Podiatric Medical, published “Mortality Rates and Diabetic Foot Ulcers: Is it Time to Communicate Mortality Risk to Patients with Diabetic Foot Ulceration?” which compared the mortality rates for a diabetes verses other diseases.

The likelihood of a diabetic being dead five years after a amputation is nearly 50%. This is more than double the chance of death from prostate or breast cancer.

Clearly, diabetics who develop foot infections need to understand the consequence of amputation is not just the loss of a toe or foot, but there is a fifty-fifty chance they will be dead in 5 years.

Loss of a foot puts more strain on the person’s heart to walk and more stress and strain on the other foot, possibly leading to sores and infection in this remaining foot.

This gives even more reason for diabetics to take care of their feet. The simple corn on the toe of the above diabetic patient can become limb-threatenting if not properly treated.

Diabetics need to check their feet everyday, watch for sores and lesions, and see a podiatrist promptly.

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