Diabetes is a disease that results in decreased production or sensitivity of insulin. Insulin is an essential hormone in the body which is responsible for using sugar from the blood for energy. A higher level of sugar in the blood can cause significant health problems. In-fact, most of these problems present first in your feet! So as a diabetic, whether you live with type 1 or type 2, it is so essential to have regular screening appointments with a podiatrist to monitor these symptoms and ensure that things do not get missed.
So how does diabetes affect your feet exactly?
High levels of sugar in the blood affect the nerves in our feet. People may lose the sensation in their feet and feel either a burning pain in their feet which is typically worse at night-time, a tingling/pins and needles feeling, numbness, or coldness in their feet. If you experience any of the symptoms of peripheral neuropathy, one of our podiatrists can have a chat with you about things you can do/use to help manage the symptoms. Unfortunately, once nerve damage has occurred, it is irreversible.
Peripheral vascular disease
Increased levels of sugar in the blood can also affect the blood vessels in our legs/feet and affect the blood flowing down to our feet. A reduction in blood flow or poorer circulation to the feet mean that it can take cuts and wounds on your legs/feet to take longer to heal. You may also experience cramping pains in your legs when sleeping or after walking short distances, pain in the feet, and changes to the skin in which you may notice a change in colour to your feet or visible veins. Diabetes can also affect the small vessels affecting your eyes, decreasing your vision.
Increased risk of infection
As wounds often take longer to heal, the risk of infection increased. This infection can sometimes spread to the bone when not managed early and can sometimes result in amputation. The feet are a exposed area of the body, meaning that sometimes even slight cuts and grazes are prone to getting infected. If you especially find it hard to look after your feet to cut and file your own nails without drawing blood or causing issues, then it’s very important to see a podiatrist about this who can look after your feet and minimise any risk of infection.
Increased pressures in feet
Decreased muscle strength and possible changes in bone structure can change the pressures in the feet. Increased pressures can result in the formation of calluses. When these are unmanaged, they can grow thick and possibly break open or form ulcers underneath.
What YOU Can Do!
With diabetes, it is all about PREVENTION! If you have diabetes, here are some things you can incorporate into your lifestyle to prevent these serious complications from occurring –
Daily foot checks
Especially for those with peripheral neuropathy, people with diabetes should be checking their feet daily for any redness, swelling, blisters, ingrown toenails, breaks in the skin, or bruises. For those who may not be able to check the bottoms of their feet as they cannot reach them or not have someone around to check the bottoms of their feet either, using a mirror can often help.
Controlling blood sugar levels
Keeping your blood sugar levels within a ‘green zone’ significantly reduces your chances of developing complications. Aim to have your diabetes reading at around 7mmol. Having a chat to your diabetic nurse about checking your simple blood sugars and controlling your diet can help you achieve this. You may also be referred to a dietitian who can help create a diet plan for you to educate you on the right foods to reduce your blood sugars. Eating a well balanced diet is one of the best ways to monitor and control your diabetes.
Turns out there is some truth in the saying ‘use it or lose it!’ It is important to make sure you are wearing appropriate footwear when exercising. It is particularly important to make sure your shoes or socks do not have any prominent seams that may cause blisters to form. In those who may need extra support, orthotic insoles are a good idea to decrease and offload pressures in the feet to prevent ulcerations from occurring.
Research has shown that smoking is a significant risk factor leading to these diabetic complications occurring. We can refer you to the appropriate services that will help you on the journey of smoking cessation.
See a Podiatrist!
Seeing a podiatrist regularly can help screen your risk for diabetes and to help with everything listed above! Our podiatrists perform neurovascular assessments to test the nerves in your feet and to check the blood flow down to your feet. By checking the pressures on your feet, your muscle strength, gait and footwear, we can determine the need for some innersoles that may help you and also prevent further problems.
Book in to see one of our podiatrists today- either through our amazing home visit service or in our clinic!
Written by Anjila Reddy, Podiatrist 2020
Edited by Claire Farquharson, Clinical Manager 2020