Many people aren’t aware of the effects diabetes can have on the foot and the lower limb. However, it is a huge medical, social and economic problem. Diabetes can affect the feet, making them more susceptible to injury, infection and amputation. In this article we will focus on two major foot complications: loss of sensation and reduced blood supply and we will give you some handy tips how to look after your feet.
Loss of Sensation
This would be a very common diabetic complication we see in our clinic. High blood sugar levels can damage the peripheral nerves which provide sensation to the feet. To put it in context, if you were to stand on a thumb tack, you may not feel the pain. This condition is called neuropathy and means that the patient has a lack of sensation or no sensation at all in the feet. As a result, these patients are at a higher risk of developing an ulcer, which is a non healing wound. Sensations such as numbness, tingling, pins and needles and burning in the feet may be all associated with changes to the nerves and should all be reported to your doctor.
A podiatrist can carry out a few quick and simple tests to check for any reduced sensations. In our clinic we use a 10g monofiliament and a tuning fork to assess our patients.
When sensation to the feet is reduced, it is very easy to buy footwear which may be too tight or too shallow as we simply don’t feel the discomfort. Damage to the nerves often causes foot deformities such as clawing toes or increased arch height and we find the joint mobility generally decreases. This will make choosing the right shoes even more difficult. Try getting your feet measured if possible when choosing a new pair of shoes and make sure it fits well. In case of patients with severe neuropathy or larger foot deformities, it is possible to order custom made footwear from trained pedorthists. At South Dublin Podiatry, we provide custom made orthotics which are devices that are placed inside your shoes. They help with distribution of pressure under your foot and keeping the foot in good alignment.
Reduced Blood Supply
Diabetes can also affect the arteries that supply blood to the feet. It can cause them to become narrow and stiff, therefore, reducing the blood supply. This condition is known as peripheral arterial disease. The main symptom of peripheral arterial disease is intermittent claudication. This is a cramp in the back of the calf and sometimes the thigh. The cramp like pain occurs due to a lack of blood supply and oxygen reaching the muscles. It occurs when walking and is usually relieved by rest.
A podiatrist can carry out a few quick vascular assessments. In our clinic, this involves taking a thorough history, checking pulses in your feet, assessing temperature and recording the capillary refill time in your toes. During each appointment we also examine your feet and lower legs for any obvious signs of vascular issues.
How Can I Take Care of My Feet?
- Check your feet daily, making sure to look in between the toes and on the sole of the foot. Watch out for any skin discolorations and cuts and contact your podiatrist if you notice any changes. If you find reaching your toes challenging, try placing a mirror on the floor and hover your foot over it.
- Apply a small amount of cream to the feet daily and avoid applying it in between the toes.
- Make sure to dry well between your toes after each shower. You can use a towel, a cotton bud or a hair dryer which is set to blow cold air.
- Avoid walking barefoot both at home and outside. On holidays, make sure to wear sandals on the beach as the hot sand may burn your feet without you realising it if your sensation is reduced.
- If you have any nail problems, callus or corns be sure to visit a podiatrist as these can lead to a skin breakdown and other problems if they’re not treated properly.
If you do suffer with diabetes, you may be entitled to a chiropody card. This card is funded by HSE and allows its holder to avail of 4 podiatry treatments per year at a reduced fee. Talk to your local HSE Health Office or call us on 0838241454 to find out more.
It is recommended that everyone with diabetes visits a podiatrist at least once a year for an overall foot check up.