Diabetes and Feet – Part 2

As we discussed in our first part of our Diabetic Foot Blog, foot complications can, unfortunately, be a common side effect in Diabetes. €˜Peripheral Vascular Disease€™ (damage to the large blood vessels of the foot/leg) and €˜Neuropathy€™ (damage to the nerves) can be caused by poor blood glucose (sugar) control and other life style factors. The good news is that side effects need not occur at all, or can be managed, by controlling your Diabetes.
What do feet have to do with Diabetes?
The diabetic foot is at greater risk of complications such as ulcers if Diabetes is left uncontrolled. Let€™s look at how you can care for your feet and how a Podiatrist can help. Your overall Diabetes will be overseen by your Diabetologist or GP, who will prescribe any medication required and advise on lifestyle and diet. They will also co-ordinate and wish to see the reports provided by your Opthalmologist for your regular eye checks, and your Podiatrist for your foot checks. These specialties help pick up any small changes in your feet and eyes early, (we monitor feet and eyes as they are the furthest from the heart and the smallest organ respectively so they show up any changes early). Any early changes can be detected and then rectified quickly, stopping any bigger impact on other organs. This is why your GP/Diabetologist will ask you to attend a Podiatrist and Opthalmologist for regular check ups (at least annually).
What does a Podiatrist do at my Annual Diabetic Foot Check?
Your Podiatrist will carry out a Diabetic Foot risk assessment at least every 12 months (depending on assigned risk category) €“ detecting risk factors and categorising accordingly.
The examination will include:
Neurological – nerve function
Vascular €“ the circulatory system
Biomechanical €“ foot function and structural alignment
Footwear assessment
There is no pain or discomfort involved in a foot assessment, and we provide a friendly environment where all your questions will be answered €“ we reserve 45 minutes for an assessment to provide plenty of time for discussion and to provide thorough examination.
What should I do to care for my feet between check-ups?
Complications can however be delayed and indeed prevented €“ with appropriate management and general self care. Manage your overall diabetes by following a healthy lifestyle and diet as advised by your GP/Diabetologist, take your medication (if any) as prescribed and attend your Opthalmologist and Podiatrist for regular check ups.
Foot Health Tips
It is vital that you take responsibility for and pay attention to the health of your feet, between Podiatry visits. If mobility is an issue, ask a carer or family member to assist with these checks, or attend a Podiatrist for regular foot care.
Foot care should include:
Daily foot screening: look over your feet at least once a day. Checking for any blisters, breaks in the skin, and signs of infection such as areas of redness, heat or swelling.
Minor cuts and blisters: If you discover a minor cut, break in the skin or blister, then take sterile precaution €“ keep the area clean by covering it with a sterile antiseptic dressing and change it daily until fully healed. Do not burst blisters. In any case you should visit your Podiatrist immediately.
Hydrate the feet daily (moisturise): The skin provides a protective barrier, keeping the external world out €“ including viral bacterial and fungal threats. It is vital that you keep the skin at its optimum condition. Diabetes can result in dry skin, so prevent this by applying moisturiser daily €“ avoiding in between the toes.
Avoid walking barefoot: you are at greater risk of injury when walking in bare feet. The skin is a barrier, simply stubbing your toe or standing on a sharp object will damage the skin and thus increase the risk of entry of infection.
Toe Nails: File your nails regularly (1/7days), following the curve at the end of the toe. Never cut down the sides of your nail as this will increase the risk of an ingrowing toe nail.
Hard skin and corns: Do not attempt to remove hard skin or corns yourself. Your Podiatrist will treat and advise accordingly. Prevention is the key €“ hydrate (moisturise) the feet and wear adequate footwear in order to reduce and prevent the formation of hard skin. Your Podiatrist can advise on the best foot creams, normally containing Urea.
Check your shoes daily: Look and feel inside the shoe €“ checking for loose stitching, folds in the lining or any objects which may have fallen in €“ all of which can result in irritation and skin breakdown. Examine the bottom of your shoe for any piercing sharp objects such as pin, needle or glass €“ all of which can penetrate through the sole.
Badly fitting shoes: Inadequate footwear is a predominant cause of foot and skin trauma. It is vital that you wear adequate footwear and avoid inadequate styles. Refer to our previous foot wear blog for information on €˜good€™ footwear or visit us for a friendly footwear assessment and information.
Socks and tights: Daily renewal of your socks and tights is vital €“ preventing fungal and other skin infections. The socks should not be tight and seam-free are a healthier option.
If you notice any change in your feet, no matter how minor – including blisters, cuts, ingrowing nails, make an appointment with your Podiatrist immediately €“ early treatment is key.

Controlling your Diabetes, blood pressure, cholesterol, leading a healthy and active lifestyle whilst having your feet assessed annually by your Podiatrist will reduce the risk of developing any foot complications.
Contact us on 04 3435390 if you are Diabetic for a friendly, informative foot check and advice.