The instance of diabetes is increasing in our population, possibly due to diet and lifestyle factors. Along with this, the number of foot related diabetes complications is also increasing.
What is Diabetes?
Diabetes occurs when the pancreas is unable to produce enough of the hormone insulin. Insulin is required to take glucose (sugar) out of the bloodstream and convert it in to energy, or store it for later use. The
resulting increase in glucose circulating in the bloodstream can cause damage to both nerves and blood vessels, particularly those in the feet (and eyes).
How Can Diabetes Affect the Feet?
Damage to the nerves resulting from diabetes can manifest itself as numbness, tingling, pain or altered sensation (e.g inablility to distinguish between hot and cold, or sharp and blunt) in the feet. In some people there are no symptoms at all.
The main issue with nerve damage arises when a person can no longer feel when they have had an injury to their foot, such as standing on something sharp and sustaining a cut, wearing shoes that are too tight, or sitting too close to a heater and burning their foot. When this happens it is called peripheral neuropathy.
Once an injury has occurred, the next problem is that the arteries in the foot can become hardened thus reducing the blood circulation. This reduces the healing potential for the wound, and also increases the risk of infection and ulceration.
How Often Should People With Diabetes Have their Feet Checked?
All people who have been diagnosed with type 1 or type 2 diabetes should have a diabetes foot examination at least once a year to monitor any changes that may be occurring in their feet. This examination evaluates the neurological and vascular state of the feet, as well as biomechanical changes that may occur due to diabetes. Having regular foot assessments means that you can be made aware earlier of any foot changes that may be occurring, and how you can manage them to reduce the risk of further complications.
How people with diabetes can look after their own feet?
As well as an annual foot assessment, people with diabetes need to check their feet themselves daily to ensure there are no injuries or infections. If you find it difficult to get down to your feet you can try using a mirror on the floor to see the bottom of your feet, or perhaps ask a trusted friend or relative to check them for you. It is also important to check between the toes for any splits or infections.
Daily care of your feet should include washing them with soap and water, drying well (especially between the toes), and applying a moisturiser (not between the toes). Footwear needs to be correctly fitted so that it is not too tight and there are no potential areas that could cause pressure.
If you notice any areas of redness, swelling, increased warmth, pain or injury you should see your health provider to have it evaluated.