There are three mains way in which diabetes can lead to foot problems – it can affect the circulation, impair sensation in the foot and change the foot shape.
A loss of sensation can be particularly dangerous as you might not even realise you’ve injured yourself unless you check your feet are ok.
It is therefore important to have regular foot health checks with a podiatrist in order to monitor these issues, to identify and/or treat any developing problems and prevent future complications.
During a diabetic foot health check at the clinic, the podiatrist will check the blood supply by feeling for pulses in the foot and assess the quality of the pulses using a Doppler ultrasound machine. They will assess the nerve sensation status of the feet by carrying out a light touch test using a monofilament and performing a vibration perception test. These tests that will identify any problems in your feet and a written report will also be sent to your doctor to keep them in the loop about your foot health status.
How To Prevent Foot Problems:
1. General measures
Ensure that you do everything you can to maintain good control of your blood sugar level. It is also very important not to smoke as it increases the chances of problems occurring.
2. Daily foot checks
You may not be aware of an injury to your feet, therefore it is important to incorporate checking your feet as part of your daily routine. If you have poor eyesight please ask a friend or relative to help you. If you cannot reach your feet use a well-positioned mirror to see parts of the foot that can not normally be seen. Look out for any signs of infection including localised or spreading redness, pain, pus/liquid, swelling, or loss of sensation/function in the area.
3. General nail cutting
It is advised that diabetics should not cut their nails because if you cut the nails yourself you could be at risk of an infection. If your nails are thickened, a podiatrist can use a nail drill to reduce the thickness of the nail and cut them too.
4. Treating hard skin
A foot file can be used to reduce hard skin and then gently rub cream over the thickened skin. This will help maintain the elasticity of the skin. For corns and very hard skin, it is best to see a podiatrist to treat the areas. Do not use a blade, razor or scalpel yourself as you cannot see how much skin you are taking off and this may cause an open wound and scarring. Also if a cut is created, it could lead to severe infection.
Wash your feet with warm water and soap. Make sure you dry carefully in between your toes, this will prevent the skin cracking. It is important to check the temperature of the bath water before you get in as you may lose temperature sensation in your feet and not realise it. This could result in you scalding your feet.
6. Socks and hosiery
Natural fibres such as cotton or wool are preferable. Change socks every day.
Always ensure that your shoes have a round wide, deep toe box and compare the shape of your toes with that of the shoe. Laces are best for fastening shoes, but buckles or Velcro straps are just as effective. A ¼ inch of space between the end of your longest toe and the end of the shoe is ideal. If your feet swell, take care not to lace, buckle or fastening too tightly. The height of the heel should not be more than one inch and the leather uppers are preferred. If possible have your feet measured before buying shoes. The best time to have your feet measured is at the end of day as feet generally swell slightly throughout the day.
Your feet may not be able to tell hot from cold. Don´t use hot water bottles or warm your feet in front of a fire. Burns can occur which may not heal easily.
Do not do the following things:
- Do not ignore any problems with feet that you are not sure about. If there is distinct colour change, any swelling, pain, heat or other abnormality seek professional help immediately.
- Do not use razor blades or sharp implements to remove hard skin as this could lead to an infection.
- Do not use corn plasters as these may contain acid which is harmful to your skin.
- Do not wear badly fitting shoes or walk barefoot.
- Do not wash your feet in strong disinfectants.
In the event of an emergency
First aid: If a minor injury occurs on your foot, cleanse with warm salt water, dry foot carefully with a soft clean towel without touching the actual wound and cover with dry dressing.
If for any reason, there are problems in contacting us, please telephone your GP immediately.