What is a Diabetic Foot?
People with diabetes are prone to having foot problems, often because of two complications of diabetes: nerve damage (neuropathy) and poor circulation. Neuropathy causes loss of feeling in your feet, taking away your ability to feel pain and discomfort. If some sensation is lost in the foot because of nerve damage, pain may not alert you to that damage has occurred. Diabetes may also reduce blood flow to the feet, making it even more difficult to heal an injury or resist infection. Poor circulation will subsequently compromise the flow of oxygen, nutrients, and white blood cells necessary to fend off infection. Because of these problems, you may not notice a foreign object in your shoe. As a result, you could develop a blister or a sore that could lead to an infection or a non-healing wound subsequently putting you at risk for an amputation.
Diabetes causes the level of sugar in your blood to be higher than normal. Over time, elevated blood sugar levels damage your blood vessels and nerves causing nerve damage and numbness referred to as diabetic neuropathy. Minor wounds often times progressively worsen forming ulcers without the person knowing it because of numbness and the inability to feel.
What is Diabetic Foot Treatment?
At Chiltern Wellbeing we take diabetes seriously because diabetes is the leading cause of ulceration and amputation. Patients with Diabetes are more likely to have serious foot problems which can lead to amputations. A diabetic foot assessment should take place annually. At the appointment, the Podiatrist will assess your feet and tell you your level of risk of acquiring a foot problem.
The Podiatrist will assess the following:
o Your vascular status including your pulses. This gives an indication as to the quality of the blood supply to the feet.
o Your neurological status. This evaluates how much sensation you have in your feet. The absence of sensation in the feet is called neuropathy. Neuropathy vastly increases your risk of foot complications
o The general condition of your feet. This includes checking for the presence of infection, ingrowing toe nails, fungal nails, corns, callus, cuts and any suspicious foot lesions.
o Your footwear. This includes giving you advice on the right type of footwear for your feet and for your chosen activity or job.
Diabetic foot care is the treatment and prevention of complications arising from diabetic feet. This includes assessing risk levels and providing advice on preventative measures. Where necessary treatment may take place in order to reduce the risk of suffering with diabetic foot complications.
Poorly controlled diabetes can lead to:
o Peripheral neuropathy – damage to the nerves supplying the feet and legs
o Peripheral vascular disease – damage to the blood vessels supplying the feet and legs
o Weakened immune system – reduced ability for the body to fight off infections
o Retinopathy – impaired eyesight
o Nephropathy – impaired kidney function causing swelling to the feet and ankles
Complications such as numbness to feet from nerve damage, and/or poor eye sight, may mean that foot injuries may go unnoticed. Any wounds that then develop may be slow to heal due to a poor blood supply, and a weakened immune system may mean the body will not be able to fight off an infection as effectively. Reaching your feet may also become difficult due to swelling caused by kidney damage.
o Regular diabetic foot screening by HCPC registered Podiatrists
o Professional advice on footwear and if required, routine foot care appointments
o A daily foot check
o Do not walk barefoot, keep your feet protected
o If you have a problem make contact with a Podiatrist or healthcare professional straight away
o Controlling your blood sugar levels
o Keeping active, to help improve blood flow
o Knowing your risk factors and the measures to take in case of an emergency
Low risk – feet without the presence of foot deformity, loss of sensation, poor blood supply
Moderate risk – feet with one risk factor: loss of sensation, poor blood supply, unable to self care
High risk – previous ulceration, amputation or diabetic foot deformity. More than one risk factor: loss of sensation, poor blood supply, unable to self care, callus or deformity
Active – current ulceration, infection, gangrene, hot red swollen foot with/without known cause.