What is Diabetes?
Diabetes is a serious complex condition which can affect the entire body, organs and systems, including the circulatory system and the peripheral nerves of the lower limb.
It is the bodies inability to maintain healthy levels of glucose in the blood. Glucose is a form of sugar which is the main source of energy for our body. Unhealthy levels of glucose in the blood can lead to long term and short term health complications.
Living with diabetes requires daily self-management and if complications arise then diabetes can have a significant impact on the quality of life and can even reduce life expectancy. Research has shown that strict compliance to medical treatment and regular exercise helps to stabilise blood glucose levels and is therefore the best way to avoid complications.
There are two common forms of Diabetes:
Type 1: The onset of type 1 diabetes is usually in people under 30 years of age however, can occur at any age. About 10-15% of all cases in Australia are type 1.
Type 2: The onset of type 2 diabetes is mainly in adults over the age of 45 but is becoming increasingly more prevalent in younger age groups including children, adolescents and young adults. Type 2 diabetes represents about 85-90% of all cases in Australia.
How diabetes can affect your feet
Your feet have a good network of blood vessels to keep them healthy. They also have a large system of nerves that act as a warning system. For example, if you have a small stone in your shoe, your nerves will detect this and send messages to your brain. However, if your diabetes is not under control for long periods of time this can lead to nerve damage which will reduce the feeling in your feet, this is called peripheral neuropathy. Nerve damage may lead to injury, wounds and infections.
Initially, changes may be small such as dryness of the skin around the toes, or tingling of the toes during the night. However, eventually this may advance to complete numbness along the sole of the foot, which then results in the loss of protective sensation and ultimately leads neuropathic ulceration. Reduced circulation to the feet and lower limbs further impacts on these neurological changes and prevents adequate oxygen supply and nutrition from reaching the extremities. You may have heard of friends or relatives with advanced Diabetes progress to foot or leg amputation and this is a real threat if overall management is not adequate.
How can I detect any changes?
Routine diabetic checks from your podiatrist can help detect changes to your feet and lower limbs before they become a problem.
As specialists in this field, our podiatrists are able to use diagnostic tests to assess your sensation, circulation and biomechanical risk factors and place that within the bigger picture of your overall health. Furthermore, a Podiatrist will provide necessary treatment at the time of your consultation for skin and nail care, corns and calluses, ingrown toenails or ulcer debridement in more advanced cases.
During our examination we also look for any general foot conditions which may lead to any future problems. We can work with you and show you how to monitor your own feet in between visits.
Depending on what we find during our assessment, you will be classified as either ‘low risk, medium risk or high risk’ of lower limb problems resulting from your diabetes. What this means for you is that we may need to see you more frequently than the once a year check-up however, it also means that you will be well looked after and reduce your chances of serious diabetic foot and lower limb related problems.
Listed below are some simple tips to help you maintain good foot health:
- The best type of footwear will fit well and allow for any swelling and or deformity within your feet as well as offering good support and protection.
- We have a good range of footwear in our clinic from the Dr Comfort range suited for the diabetic feet. We are able to order our footwear made to measure for your feet to ensure a correct fit.
- Where possible wear lace up/velcro fastening shoes which are deep and broad enough especially in the toes.
- Check daily inside your shoes for rough edges or exposed tacks – shake them out to ensure there is nothing inside.
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/footwear.
- Have corns, calluses and other related problems treated by a podiatrist.
- Seek advice as soon as you have any concerns.
- With altered sensation you may experience numbness in the feet and lower limbs. Cuts, blisters, ingrown toenails and corns may go unnoticed.
- Reduced blood supply (poor circulation) can slow down the healing process.
- Inspect your feet daily
Healthy feet provide the foundations for a healthy body and an active life!
Dr Peter Shelton BSc Hons. Accredited Podiatrist.