Diabetic Foot problems can include the development of ulcers, cracked skin, reduced foot sensations, altered foot shape (Charcot’s foot) and infections. In some cases, these can require surgery or even amputation of toes, feet and legs when left unchecked. By visiting a Podiatrist 2-4 times a year, you significantly lower your risk of developing diabetes-related foot problems. Podiatry visits for Diabetic Foot Care are bulk billed at our clinic so no out-of-pocket expenses!
According to Diabetic Foot Australia, on any given day in Australia, there are 50,000 Australians living with diabetic foot disease, 12,500 who are living with diabetes-related amputation, with 12 people every day undergoing an amputation as a result of diabetic foot disease. A big goal of a podiatrist is to avoid any complications, which can occur as a part of the diabetes process.
What we tend to overlook if you happen to have type 1 or 2 diabetes is how this impacts our feet, and usually, we don’t pay attention to our feet until they become a problem. Glycaemic control impacts the entire body; a common complication associated with diabetes, is diabetic foot disease. Diabetic foot disease is a broad term used to describe the complications seen in diabetics; this typically includes peripheral neuropathy and peripheral vascular disease.
Peripheral Neuropathy is where the nerves in the foot and leg as misfiring, this can lead to numbness, tingling, burning or altered sensations. Where this can become a big risk is that often you can’t feel your feet, and if you tread on something this will go unnoticed or stumbling increasing the risk of a fall.
Peripheral Vascular disease is more common in the diabetic community, where there is a hardening and narrowing of the arteries leading to the feet. Poor blood supply reduces the flow of nutrients and oxygen reaching the body’s tissues, ultimately resulting in ulcerations – slow/non-healing wounds on the feet and if left unchecked, infection and gangrene. As the feet are the furthest distance from the heart they are most affected extremities.
A combination of these two are serious risk factors and if ignored the ultimates price is paid – amputation to avoid septicaemia! Proper Management of the Diabetic foot is essential and our Podiatrist Dr Ella Wright recommends the following:
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- Daily foot inspections: Even wearing shoes there is still a big risk of developing lesions that you can’t feel, ideally inspect your feet twice a day for any ulcerations developing. It is much easier to manage these when they are small
- Moisturiser: The nerves not only are responsible for what you feel but are also responsible for your sweat glands, which can stop working leaving the foot very dry, prone to cracking and fissuring and ulceration. Intact skin is your major defense against infections
- Appropriate Footwear/Accommodative orthotics: When you consider that the feelings in your feet aren’t the best there is a very real risk of rubbing, blistering and pressure that you would otherwise feel. Wide accommodating footwear with no significant seams which can dig in is recommended. Accommodative orthotics can also help deflect any areas of rubbing, especially in those who have had ulcerations in the past or suffer flat feet.
- Optimal Glycaemic Control: Ideally a lot of the complications can be avoided with optimal glycaemic control, be that through medication or diet. Typically the worse your blood sugars the worse the complications and the harder it is to recover.
- 3-6 month foot reviews: Booking in 2 to 4 times a year to see your podiatrist is essential for diabetics, regular reviews will show any progression of neuropathy as well as monitoring the foot blood supply. Ongoing education at these foot reviews is always essential to keep people on track and avoid any complications associated with diabetic foot disease.