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Every year about five percent of all diabetics develop a foot ulcer. Of those who do, about 20 percent of diabetics with a foot ulcer will have to have the foot (or feet) amputated. Diabetic foot ulcers are a very serious condition.

It's possible to be free of other diabetes complications, such as retinopathy, kidney disease, and cardiovascular disease, and still develop a foot ulcer. That's because the complication that causes the predisposition to skin problems on the feet seems so trivial.

Most diabetics develop neuropathy in their feet. The feet tingle and burn. Then they lose sensation, and diabetics quit paying attention to them. 

It's possible for diabetics to step on nails, break bones, or develop raging infections and not feel any pain, but most diabetic foot ulcers don't start with anything that large. Most diabetic foot infections start with a tiny crack in the skin of the foot that gets infected with bacteria.

Staph bacteria that grow on the floor of the bathroom are frequently the problem. It's also possible to get foot infections with the bacteria that cause urinary tract infections. They get washed off the openings of the urinary tract onto the feet and take hold in the tiny cracks in dry skin on the feet.

Conversely, once you get a foot infection, the bacteria can live for years in the bowel. It's not that people put their toes up there. It's that the bacteria get transferred from the infected foot to the hands, from the hands to the mouth, and from the mouth to the bowel. 

For this reason, just about the only way to get rid of a diabetic foot infection is also to get rid of the same bacteria in the bowel. Doing this requires intravenous (IV) antibiotics. 

Ironically, the time you are likely to get a flare up of a diabetic foot ulcer is just after you take an antibiotic for an infection somewhere else. This kills the probiotic, friendly bacteria in your colon that keep the foot ulcer bacteria in check. They wash down to your feet and the infection starts all over again.

There really aren't any supplements that are heavy-duty enough to fight foot infections. It's a good idea to take a probiotic to keep your your friendly bacteria from being wiped out, but this doesn't help with your foot. You simply have to have prescription antibiotics. You have to have the right antibiotics for the particular kind of infection you have. There isn't any one antibiotic that works for every infection. To do that, you have to go to a doctor who knows how to do microbiology or a hospital that has an infectious disease specialist. Moreover, it takes at least 48 hours to get even preliminary results, and the first thing your doctor tells you can be contradicted by later results. Treating foot ulcers is extremely complicated.

I know this because I have spent six weeks in the hospital in the past three months because of an itty bitty cut on the bottom of my big toe. I was in the hospital twice, getting IV antibiotics, when I got sent to a nursing home. This wasn't because I'm old. It was because I had to have a nurse wrap my foot twice a day and I had to wear a special waterproof boot every time I went to the bathroom.

I spent two weeks in the nursing home and I had to go right back to the hospital for a third time. Why did my treatment fail? The doctor at the nursing home decided to give me a very high dose of the wrong antibiotic. It killed all the friendly bacteria, and let the particular disease-causing bacteria I had grow out of control. The wrong antibiotic can be worse than no antibiotic at all. It took another week in the hospital to undo that mistake.

Don't make the mistakes I made. If you are diabetic:
  • Make sure the skin of your feet and lower legs doesn't dry out. Use a moisturizer, one that doesn't contain alcohol or perfumes. In the US, a product called Eucerin works well.
  • If you get a foot infection, throw out your old shoes. They can harbor germs, and keep infecting your foot over and over again.
  • Pay attention to redness. A rash that "moves" is possibly an infection. On the other hand, either peripheral artery disease or venous insufficiency can make your legs red. They will cause redness in the same place all the time.
  • Make sure your shoes fit perfectly. If your foot rubs against your shoe every day, it can develop a callus. The callus cuts off circulation to the part of the foot that is further down from it. This keeps your immune system from fighting infection if you get even a tiny cut. If you do develop a callus, you need to see a podiatrist to get it removed. Don't try to cut it off yourself. If you aren't very careful, you can do even more damage than would occur if you just left it alone.

Just a word about noni juice is in order here. It really doesn't cure gangrene. It doesn't act fast enough. If you develop gangrene, you don't have very long before you have to get medical treatment. Gangrene can eat away flesh in just hours. I know. It's happened to me. A really good doctor is what you need very quickly, not a supplement or a juice a few weeks or months from now.

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