World Diabetes Month

Diabetes

November is the worlds diabetes awareness month. To recognise this systemic disease, it is important to discuss the impact it has on foot health.

As a healthcare professional specialising in feet, I am constantly surprised at the little information a patient has been provided about diabetes and the impact it has on the feet. Many people are entirely unaware that they need to take special care of their feet.

Podiatrists play a key role in providing appropriate footcare for people with diabetes. The key to preventing diabetic foot complications is early recognition and regular preventative foot screenings.

Complications associated with the diabetic foot:

·      Changes to skin integrity (dry, cracked skin)

·      Changes in structure of the feet

·      Compromised blood supply to the feet

·      Nerve damage and sensation loss to the feet

·      Leading to inability to heal wounds

·      Limb amputation

How can a Podiatrist help?

Preventing and managing diabetic foot complications can be achieved through a vascular, neurological, biomechanical and footwear assessment.

Vascular assessment:

·      History of vascular supply, such as cramping, leg pains or claudication

·      Quality and palpable foot pulses to assess blood flow to the feet

·      Venous return problems, oedema, or varicose veins

·      Correct referral pathways can be used to vascular specialists at this early stage of diagnosis

It is vitally important to have an adequate supply of blood to the feet – poor circulation results in slow healing or inability to heal.

Neurological assessment:

·      Any history of neurological symptoms such as burning, numbness or pins and needles

·      Tuning fork testing is used to assess the quality of the vibration sensation in the foot – this is important as it is often the first sensation to diminish with neurological complaints

·      Monofilament testing is used to assess your protective pain sensation, if this is not appreciated the patient could be at increased risk of not feeling pain.

Good sensation is extremely important – if it is diminished it can hinder your ability to feel trauma, therefore you are unable to prevent damage to the foot leading to cuts, burns and wounds to the foot.

Biomechanical assessment:

·      Foot structure and walking patterns can be assessed to look for areas of high pressure or deformities.

·      High pressure areas are at risk of corns and callus, which can lead to diabetic foot wounds if left untreated.

·      Implementing steps to reduce this pressure via padding, footwear modifications and orthotics can help.

Footwear assessment:

·      Footwear is assessed to observe any abnormal wear patterns or abnormalities.

·      The inside and outside of the shoe will be checked to ensure it provides enough support and shock absorption.

·      Finally, the width and depth of the shoe is checked to ensure they fit correctly and comply with the ideal features of a diabetic shoe.

Tips to prevent foot complications:

·      Daily foot checks – taking note of any cuts or inflamed skin.

·      Keep your feet clean – making sure to dry thoroughly between the toes.

·      Moisture – keep your feet soft and supple with daily moisturising.

·      Avoid bare feet – this helps to avoid cutting/damaging the foot.

·      Keep active and maintain a healthy diet – glucose control is essential.

Still need help? Please contact us today.