Diabetes and Your Podiatrist/Chiropodist

Diabetes affects both the nervous and vascular (blood) system to the feet, if left unmanaged. Neuropathy (nerve damage) and decreased blood flow result in increased risk of complications developing in the lower limbs.

How does diabetes actually cause problems to the feet?
If diabetes is poorly controlled this can lead to the loss of protective sensation (sensory neuropathy) means that the diabetic patient may not detect the presence of a sharp, hot or cold object against the skin of the feet. This often then leads to unnoticed skin wounds. Wound healing requires adequate blood supply, decreased blood supply in a Diabetic foot results in poorer wound healing than in those with better circulation. Undetected and slow healing wounds also then increase the risk of infection €“ infection will pose a serious complication in any diabetic foot.

So what can you do?
Daily foot screening should be a part of your diabetic foot care. Assessing your feet quickly at night €“ looking for any cuts, bruising, swelling, signs of pressure areas, warmth, scratches and blisters, will prevent the development of severe complications. If mobility is a problem and you find it difficult to look a the soles of your feet, use a mirror with a long handle or ask a relative / carer to help check your feet.

Protect your feet at all times

Basic Foot Care Advice: Do€™s and Don€™ts for Diabetics
• Always keep your feet warm €“ cold (air con) temperatures will cause constriction of the arteries and thus reduce the volume of blood flowing to your feet. Wearing socks and closed footwear when exposed to air con, will maintain adequate blood flow to your feet.
• Don’t be tempted to walk bare foot on the beach. The sand€™s temperature is often high enough to burn the skin on the sole of your feet and unseen objects such as shells or broken glass can cut through the skin. Protect your feet by wearing footwear when on the sand.
• Don’t smoke! Smoking damages your overall health including blood circulation, worsening any side-effects of diabetes.
• Avoid sitting with your legs crossed, as doing so will decrease the oxygen/blood supply to your feet.
• Don’t soak your feet for long periods. As relaxing as it may be, socking your feet in a tub of warm water is by no means therapeutic for the feet. Skin will become dry if kept in water for a lengthy period €“ hard working dish washing hands are dry for this reason!
• Don’t use antiseptic solutions or pharmacy bought medications without the advice/prescription of your Doctor, or heating pads or sharp instruments on your feet. These are all likely, due to the lack of protective sensation in the diabetic foot and if incorrectly used, are more likely to cause damage than help.
• Trim your toenails straight across. Avoid cutting the corners. Use a nail file or emery board. If you find an ingrown toenail, contact our clinic for qualified and correct care. If you find regular footcare difficult at home, visit your Podiatrist for regular chiropody foot care sessions.
• Use emollient foot cream once daily, to keep the skin of your feet soft and hydrated, but do not apply it between your toes. There are various excellent moisturizers available from our clinic containing urea.
• Wash your feet every day.
• When drying your feet, pat each foot all over with a towel €“ making sure you get in between the toes.
• Buy shoes that are comfortable without a “breaking in” period. Check the adequacy of your shoes. Make sure they fit not only in length but in width, assess the back (it should be hard), bottom of heel, and sole. Avoid pointed-toe styles and high heels. Don’t wear the same pair of shoes every day. Inspect the inside of each shoe before putting it on €“ folds and stitching in the inner toe box will rub upon the skin and result in skin wounds. Don’t lace your shoes too tightly or loosely.
• Choose socks/stockings carefully. Wear clean, dry socks every day. Avoid socks with holes or wrinkles or seams that cause friction. Thin cotton socks are more absorbent for summer wear. Square-toes socks will not squeeze your toes. Avoid stockings with elastic tops as they often restrict the circulation. Special gel socks are also available for moisturising if you have dry skin, which is more common amongst diabetics and must be moisturised (to avoid callous and cracking).
• Attend a specialist podiatrist experienced in Diabetic Foot Care and Management for at least an Annual Diabetic Foot Assessment. They will thoroughly assess your feet and legs and pick up early warning signs if your foot health has gotten even slightly worse since your last visit. This means your overall management including medication may need to be revised, before any more serious damage is done to your organs or rest of your body. You should also see a Podiatrist immediately if you notice any changes in your feet, including blisters, cuts or a change in sensation.
• You should also see an Opthalmologist for an Annual Eye Test for the same reason: early detection to any changes is vital. The Opthalmologist and Podiatrist will give you a detailed written medical report for you to show and discuss with your Diabetologist / GP who manages your condition with you.
Contact Dubai’s chiropody/podiatry foot experts on +971 4 3435390 for a friendly, informative and stress and pain free assessment today.