Diabetic Foot Care

What is Diabetes?diabetic footcare

Diabetes Mellitus is a disease that affects the way the body uses food. The food we eat is converted into sugar (also known as glucose) by a hormone called insulin. Insulin is produced in the pancreas (organ near the stomach) and is needed to convert sugar, starches and other food into energy for the body. When you have Diabetes, your pancreas does not produce or properly use insulin and this causes you to have high blood sugar.

There are two types of Diabetes, Type 1 and Type 2.

Type 1 Diabetes:

The body does not make insulin to regulate blood sugar levels.diabetes-booklet.png

Insulin needs to be injected into the body.

Often develops before you are 30 years old.

Used to be called Juvenile Diabetes or also known as Insulin Dependent Diabetes Mellitus (IDDM).

Type 2 Diabetes:

The body does not produce enough insulin or the body’s cells cannot use it.

A modified diet and/or the use of oral medication (hypoglycemic tablets) is needed.

Usually develops in adults over 40 years old.

What Causes Diabetes?

The cause of Diabetes is unknown, but certain risk factors are associated with Diabetes. These include:

Family history
High blood pressure
High Cholesterol
Inactive lifestyle
Age (40 yrs +)

How do I know if I have Diabetes?

There are well known symptoms that your healthcare provider will look out for, known as the “Diabetes alerts”.

Symptoms include:

Dehydration therefore increased thirst
Increased hunger
Increased urine output
Weakness or Fatigue
Dry skin
Increased risk of infections
Slow healing time of any sores (e.g. scratches/bites)
Blurry vision

How will my Diabetes be treated?

Diet and lifestyle can help keep your blood sugar level at a normal level. However, sometimes tablets and/or injecting insulin is required if these changes do not work.

A normal blood glucose level in non-diabetics is within a reading of 3.5-6.5m/mols/l. and a well controlled diabetic's glucose level should fall within 4.0-7.0 mmols/l.

Why do I need to worry about my feet?

Foot problems:

  • Foot deformity – e.g. clawed toes, hammered toes, Charcot foot (deformity of the forefoot, midfoot and ankle. It is only associated with total loss of feeling in the feet – neuropathy usually occurs in one foot which has good circulation).
  • Neuropathy - when the protective sensatiion on the feet is lost. Neuropathic symptoms can be either a heightened sensation of nerve pain, burning, tingling, pins and needles or numbness (can be associated in the hands too).
  • Reduced or poor circulation – pulses in your feet are weak or not found when felt with the fingertips. You may also suffer with cramps in your calf muscles when walking (also known as intermittent claudication).
  • Nail deformity – thickened nails
  • Excessive callus build-up or corns
  • Ulceration
  • Gangrene
  • Amputation

Facts about amputations:

50% of lower limb amputations are associated with Diabetes

70% are preceded by a foot ulcer

15% of Diabetics will develop a foot ulcer

4 out of 5 foot ulcers are precipitated by external trauma

Up to 20% undergo amputation to one side of the lower limb

Up to 50% undergo a second amputation within 1-3 years and 50% within 5 years

3 years mortality after amputation is 20-50%

Preventing Foot Complications

  • Never attempt to use a scalpel or sharp object on hard skin or corns as you may make the skin bleed. You should see a Podiatrist who is specially trained in removing hard skin and corns.
  • Do not pick or pull at nails or hard skin as you could cause ingrown toenails or make the skin bleed.
  • Try NeuRemedy to improve your nerve health by boosting vitamin B12.
  • Never walk barefoot.
  • Check feet daily for cuts and abrasions. If you have difficulty checking your feet you can try to use a mirror under the foot or get a family member or friend to check your feet.
  • Wear correctly fitted and protective shoes.
  • Wash and dry feet thoroughly and regularly.
  • Change socks daily and avoid seams in socks as they can catch on toenails. There are specially designed socks for diabetics or some sports related socks that have limited seams which may be more suitable. Alternatively you can turn your socks or stockings inside out.
  • Moisturize daily (but not between the toes).
  • Do not use corn plasters or acid based treatments.
  • Avoid hot water bottles in bed or sitting too close to the fire or heaters as the skin can burn without you feeling it if you have neuropathy.
  • Check temperature of baths with your elbow if you have neuropathy – never put feet straight into a hot bath in case of scalding the skin.
  • For any minor wounds, you should clean the area in salt water or antiseptic solution, apply a dry dressing and watch for signs of infection.
  • Signs of infection – redness or streaking of the skin, swelling, increased heat, yellow discharge (pus), sensation changes, fevers or chills and possible malodour to the wound.
  • See your GP if infection is suspected as you may require antibiotics.
  • Annual health checks can be done by your GP, practice nurse or Podiatrist (for the feet).