What is it?

Diabetes is a condition that results in elevated blood sugar levels. This causes a number of complications for the whole body, in particular the feet.

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

• nerve damage or “peripheral neuropathy” and/or
• reduced blood supply/circulation or “peripheral vascular disease”

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

If you have reduced circulation, any injuries or infections to your feet (e.g. cuts, burns or scratches) will take longer to heal. This is due to less blood flowing through the arteries of your feet.

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

How can I detect any changes early?

A yearly foot health 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 that may lead to future problems. They will work with you to show you how to monitor your own feet between visits.

What can I do to prevent problems?

• Protect your feet from injury
• Inspect your feet every day (your podiatrist can show you how to do this properly)
• See your podiatrist immediately if something is not healing
• Maintain acceptable blood sugar levels (between 5-8mmol/L)
• Don’t smoke
• Exercise regularly
• Avoid barefoot walking
• Apply moisturising cream to feet daily (not between toes)
• Keep your feet clean
• Wear well fitting shoes
• Cut and file nails carefully or have a podiatrist maintain them if you have difficulty
• Have corns, calluses and other foot problems treated by a podiatrist
• Avoid commercial corn cures
• Keep any cuts and sores dressed with bandaid or cutiplast and use an antiseptic (betadine)

Footwear advice for diabetic patients

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

• Where possible, wear lace-up or velcro 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
• Wear cotton or wool blend socks and change these daily. Make sure the tops of your socks are not too tight.

Remember

• Altered sensations may lead to numbness in the feet. Cuts blisters, ingrown toenails and corns may go unnoticed.
• Reduced blood supply/circulation can slow the healing process
• Protect your feet from injury
• Inspect your feet every day
• Have a Regular foot assessment