Diabetic Foot Care

What is diabetes?

Diabetes is a disease that develops from high blood glucose levels which can cause damage to the nerve systems in your body by stopping important messages getting to and from your brain. The nerves most likely to be affected are the longest ones – those that reach all the way down to your legs and feet. This nerve damage is sometimes called neuropathy.

 

High blood glucose levels can also damage your blood vessels and thereby circulation to your feet and legs, due to less blood getting to your skin, muscles and tissues.

 

Is it serious?

Any injury or hard skin has the potential to develop into something more serious if you have diabetes. When the skin is damaged, it may not heal so easily and sometimes this can cause an ulcer to form on your foot. Additionally, if you have lost feeling in your feet then it is possible that you may unknowingly damage your feet. You may stand on sharp objects like a nail, piercing the skin even down to the bone without realising it. If not noticed and not treated appropriately this can have potentially serious consequences and could lead to an amputation. Such an outcome is less likely if you seek expert advice from your multidisciplinary foot care team.

 

Who gets it?

Anyone can suffer from diabetes and you are more likely to if your close relatives have the disease. Other risk factors include obesity, high cholesterol and blood pressure as well as physical inactivity and your chances also increase as you get older.

 

How do I know I have it?

Diabetes may affect your feet in a number of ways. One of the early changes can be loss of sensation (peripheral neuropathy) in your feet, often starting at the toes. Your chances of losing feeling in your feet (neuropathy) increases with the number of years that you have diabetes and research suggests that up to one in three people with diabetes have some loss of sensation. The onset of neuropathy is gradual and often people who develop this complication are unaware of it at the start. Often it occurs between 7 and 10 years of having diabetes, although in some cases it can occur sooner where blood sugar levels have not been so well controlled. Very occasionally pain or a burning sensation may accompany loss of feeling (painful neuropathy).

 

Another change that can occur is reduced blood flow to your feet. Diabetes may also affect your ability to heal and reduce your natural ability to fight bacteria. Consequently, you should take particular care of any scratches, cuts or blisters on your feet.

 

What are the treatments?

If you have diabetes, you should see a podiatrist regularly throughout the year. However, if you are at increased risk of an ulcer, appointments should be more frequent. The podiatrist will normally check both the blood supply to your feet and any evidence of loss of sensation in your feet. Blood supply will be checked by looking at the colour of the skin, checking the pulses in the feet and by asking questions about certain kinds of pains in your feet and legs.

 

Normally people have two pulses in their feet: one on the top (dorsalis pedis) and one on the inside of the ankle (posterior tibial). Most often the podiatrist will check these pulses by feeling the pulse with their fingers or they will use a small hand held scanner (called a doplar) to listen to the pulse.

 

Sensation will most commonly be checked with a monofilament and tuning fork. The monofilament is a plastic probe that is designed to buckle at a given pressure and is a good indicator for loss of feeling. The podiatrist will also be looking for any foot deformity or signs of excessive loading that may warrant either footwear advice or in some cases an insole.

 

When should I see a podiatrist about it?

If you experience any form of neuropathy or pain or discomfort, it is advisable to consult your diabetic clinic or podiatrist, since it is possible in many cases to alleviate these symptoms.

If you see any of the following in your feet, you should also seek medical attention or consult your podiatrist:

• Walking becomes more difficult

• Applying or wearing shoes becomes more difficult

• Tingling sensation or pins and needles

• Part or all of your foot becomes swollen

• Breaks in the skin, opens sores/blisters or a discharge

• Skin colour changes (redder, bluer, paler, blacker) over part or all of the foot

• Swelling in your feet and/or an unusual odour

• Part or all of your foot feels much hotter or colder than usual

• Hard skin (callus)

• Cramp in your calves

• Shiny smooth skin and/or losing hair on your feet and legs

If you do not qualify for this, or need urgent attention, you should contact a private podiatrist.

 

Call us today on 01279 438444 to find out more about diabetic foot care or to book an appointment at our well established, friendly Chiropody & Podiatry clinic located in Old Harlow. We are well located and are happy to see patients from any area including Sawbridgeworth, Bishop's Stortford, Epping, Roydon, Nazeing, Broxbourne, North Weald, Loughton, Ongar, Stanstead and beyond.