Diabetes is a condition in which a persons body cannot maintain healthy levels of glucose (a form of sugar) in the blood. Glucose from the food we eat needs to be converted into energy that the body can utilise, however with diabetes this is not performed efficiently. In Type 1 Diabetes, the pancreas is unable to produce the hormone insulin (insulin allows the body to use sugar as energy). However, in Type 2 Diabetes the pancreas either does not produce enough insulin, the insulin does not work effectively on glucose and/or the body does not respond to the insulin properly (this can also be called insulin resistance).
In both Type 1 and Type 2 Diabetes, the unused glucose stays in the bloodstream, resulting in high blood glucose levels which can cause ongoing short and long term health complications. There is no cure for diabetes – but it can be effectively managed through diet, exercise and in more advanced cases, medication or insulin injections.
So if diabetes is a condition related to sugar, then it has nothing to do with my feet right?
Wrong!
Poorly controlled diabetes can cause a host of issues related to the feet, usually stemming from either nerve damage or reduced blood flow.
PERIPHERAL NEUROPATHY
Peripheral neuropathy is a condition which causes reduced or altered sensation in the feet (and hands). It can present as numbness, feelings of burning, tingling or shooting pain in the feet and lower legs, as well as weakness and wasting of the muscles in the feet. As a result, you may develop foot complications such as:
Sores, ulcers and infections due to not feeling injuries to your feet
A decline in balance and co-ordination, which may lead to tripping or falling
POOR CIRCULATION
Reduced blood flow/poor circulation to the feet is also associated with poorly controlled diabetes. Symptoms include cold feet, hair loss on your feet, dry or cracked skin and brittle toenails.
It is important that when poor circulation is present, that you take extra care to protect your feet from injury! This is because injuries will take a longer time to heal – or potentially not heal at all, and it also affects your body’s infection fighting ability. With some non-healing diabetic foot ulcers, amputation of the affected limb is required – in Australia alone there are more than 4400 amputations every year as a result of diabetes.
Smoking, high alcohol intake, high blood pressure and high cholesterol have all been associated with increased risk of diabetic complications, such as neuropathy and reduced circulation.
Whilst there is no cure for diabetes, there are ways you can reduce your risk of developing foot complications:
GENERAL FOOT CARE:
Always wear shoes to protect your feet from injury
Perform daily foot inspections, and keep them clean
Use moisturisers to avoid dry skin and improve your skin integrity: moisturised/hydrated skin = strong skin! Do not apply moisturiser between your toes though!
Have a regular foot assessment with a podiatrist
Have corns/callous/nail care performed by a podiatrist – we use sterilized instruments and follow strict infection control guidelines
See or phone your podiatrist if something is not healing or if you find a red/swollen area that you hadn’t noticed before! Do not rely on pain as a guide, especially if you have nerve damage!
Maintain steady blood sugar control with a healthy balanced diet and regular exercise
If you do have a new cut/scrape/open wound:
Flush the area with clean water
Apply Betadine or another equivalent antiseptic
Cover with a non-stick dressing (i.e. a Band-aid) and keep it dry
Repeat the above steps daily until the wound heals
WEAR APPROPRIATE FOOTWEAR:
Wear lace-up or buckle/Velcro closed shoes
Ensure shoes are deep and wide enough, especially around the toes
Check the inside of your shoes for any rough spots, and shake them out before putting them on – just to make sure there is nothing inside them which may damage you skin
Shoes with neoprene upper material are stretchy and soft, so are good for feet with wayward toes and lots of “bumps”
Don’t wear tight socks or knee high stockings, or anything with prominent seams
If your shoes and socks are worn out – throw them out!
Get professionally fitted for footwear
HOW CAN YOUR PODIATRIST HELP?
A 6-12 monthly check by your Podiatrist will help to detect any changes, before problems start
Your Podiatrist will examine your circulation by feeling your foot pulses, and if required a Doppler ultrasound or toe blood pressure will be conducted
We will examine your feet for general foot conditions which may need attention
We will work with you to show you how to take care of your feet in between consultations
We will report back to your GP on your foot health status regularly
If you would like to book a diabetic foot assessment or would like more information, call us at Lakeside Podiatry on 5821 3006, or book an appointment online.
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