Foot Problems - diabetes

What is diabetes?

Diabetes is a condition in which the amount of glucose (sugar) in the blood is too high because the body is unable to use it properly. This is because the body’s method of converting glucose into energy is not working as it should.

THERE ARE TWO COMMON FORMS OF DIABETES:

• Type 1, also known as insulin dependent diabetes. This usually affects children and young adults. People with this type of diabetes require daily insulin injections.
• Type 2, also known as non-insulin dependent diabetes, is by far the most common and usually affects people over the age of 40 years.

How diabetes can affect your feet

Your feet are supplied with blood to keep them healthy. They also have a multitude of nerves that act as an emergency warning system. For example, if you have a stone in your shoe, nerves will send a message to your brain to investigate.

However, if your diabetes is poorly controlled for a long period of time, this may lead to:

• nerve damage, or ‘peripheral neuropathy’, which impairs sensation to the feet, and/or
• reduced blood supply, also known as ‘poor circulation’.

Nerve damage may mean that you no longer notice the stone in your shoe, due to loss of sensation to your feet. This could then lead to an injury you can’t feel, and possibly infection.

Be treated seriouslyIf you have poor circulation, any injuries or infections to your feet (ie cuts, burns or scratches) will take longer to heal. This is due to less blood flowing into the arteries in your feet. Blood provides energy to working muscles and aids in healing any tissue damage.

If you have poor circulation, you will need to take extra care to protect your feet from injury.

Most foot problems in people who have diabetes occur when injuries — and often infections – go unnoticed and untreated, or when healing is delayed due to poor circulation.

How can I detect any changes early?

A six monthly foot assessment by your podiatrist will help to detect any changes early — before they become a problem.

In an assessment, your podiatrist will examine your circulation by feeling foot pulses. They will also examine sensation by testing reflexes, vibration and pressure sensitivity.

Your podiatrist will also look for general foot conditions which may lead to future problems. They will work with you to show you how to monitor your own feet, in between consultations.

TO PREVENT PROBLEMS

• Protect your feet from injury
• Inspect your feet every day (your podiatrist can show you how)
• See your podiatrist immediately if something is not healing.

AS A GENERAL GUIDE:

• Maintain acceptable blood sugar level control
• Don’t smoke
• Exercise regularly
• Avoid barefoot walking
• Keep your feet clean
• Wear well-fitting shoes
• Cut and file nails carefully
• Have corns, calluses and other foot problems treated by a podiatrist
• Seek your podiatrist’s advice before using a commercial corn cure

Footwear advice

The best type of footwear fits well and protects your feet. Wherever possible, wear shoes to avoid injury.

Some other pointers:

• Where possible, wear lace-up shoes as they don’t cause foot and leg fatigue or lead to toe-clawing.
• Check inside your shoes for rough edges or exposed tacks — shake them out to make sure there is nothing inside.
• Cotton hosiery, socks and tights, worn with leather upper shoes are good choices.