Diabetic Foot Care

Diabetic clients develop problems with the smaller blood vessels which service the feet.

What is it with diabetes and feet?

OK, as the circulation deteriorates, so does the person’s nerve and muscle structures that rely on that blood supply. This in turn may lead to numbness and muscle wasting in the feet. Also the person’s ability to detect a problem is decreased exposing them to the risk of greater injury , infection or ulcerations. Regular routine neurologic, vascular and gait examinations are very important to maintaining the foot health for our growing diabetic population.

Why do people get Diabetes?  

Diabetes happens when the body doesn’t produce enough insulin. Insulin controls how much glucose can pass from the blood into the body’s cells.  This results in higher blood sugar levels which can damage the blood vessels and nerves in the body. Of those people with diabetes, it is estimated that 25% will develop foot problems related to the disease from a combination of causes.  People with diabetes should pay particular attention to their feet and legs, because they are prone to foot problems such as:   Loss of feeling and circulation in their feet, changes in the shape of their feet, increased rate of infection in the feet and legs and foot ulcers or sores that do not heal and

Regular assessment of the feet and legs is strongly recommended in diabetics every 6-12 months to detect early changes in neurological or vascular deficiencies.

Leg and foot problems are the most common reason for diabetes-related hospitalisation, and diabetes related problems are the leading cause of non trauma amputation in the lower leg and foot. Vascular testing is important to help diagnose inadequate blood flow in the legs and feet, whilst neurological testing determines if your diabetes is having an affect on the sensation in your feet. These tests are quick, painless and can be performed by your podiatrist.

Neuropathy 

Diabetes can affect the nerves in your feet. Nerves are the ‘wiring’ of the body. They carry feelings to the brain from the rest of the body. The nerves to the feet are the longest in the body and the most likely to be affected by diabetes. Diabetic Neuropathy can cause insensitivity or a loss of ability to feel sensations such as touch, pressure, vibration, pain, position in space, heat and cold. A person whose nerves are damaged by diabetes may not realise they have cuts, corns, blisters, pressure sores and in extreme cases ulcers or damage that may end up leading to an amputation. Neuropathy can also cause deformities such as Bunions, Hammer Toes, and Charcot Feet.

As well as a loss in sensation, nerve damage can cause Pain or numbness in the feet, Pins and needles or shooting pain in the feet and sometimes burning sensations, particularly on the soles of the feet.

Prevention of neuropathy is very important in diabetics as once the nerves are destroyed, sensation rarely improves. It is important for those who do experience a loss of sensation to protect their feet as much as possible from harm. Daily foot checks are extremely important, as is timely treatment for cuts, bruises, burns, redness, cracks or blisters etc. The good news is that when a diabetic person takes the necessary preventative foot care measures, he or she reduces the risk of serious foot conditions significantly.

Poor Circulation

Diabetes often leads to peripheral vascular disease which reduces the amount of blood flow to the feet. Poor circulation can lead to a number of problems. When the blood vessels are damaged vital oxygen and nutrients have trouble getting to the feet. A lack of circulation can lead to swelling and dryness of the feet and can impair the healing process. Poor circulation can also lead to ulcers, infection, and other serious foot conditions.

Common complaints due to poor blood supply include Cold feet, Painful legs (in particularly the calves) when walking, Painful calves in bed at night and decreased healing rate in feet.

You can improve circulation if you avoid smoking and decrease caffeine, maintain an active life and control cholesterol, blood sugar levels and blood pressure.

Prevent Foot Problems

• Keep you blood sugars within normal healthy level
• Check feet daily for any signs of injury or changes. You may need a mirror to look at the bottoms of your feet or even get a little help from someone else if required.
• Wash feet daily and dry well between the toes to avoid problems such as tinea.
• Cut toenails straight across and file rough edges to avoid ingrown toe nails. It may help to soak your toenails in warm water to soften them before you cut them.
• Avoid injury by wearing well-fitting, protective shoes.
• Have corns or calluses treated by a podiatrist.
• Keep the skin on your feet in good condition by moisturising daily. Avoiding putting cream between your toes to reduce the risk of tinea.
• Don’t let your feet get too hot or too cold.
• Don’t go barefoot (especially outside).
• Avoid talcum powder where possible.
• Choose appropriate shoes and socks for diabetics

Contact Bentley Podiatry today for more information.