Foot Sensation & Diabetes

What is Diabetes?
Whether you are borderline or pre diabetic, newly diagnosed or have managed your Diabetes for years, your Podiatrist will be a key member of your healthcare team. Diabetes is a condition that means your body cannot process glucose (sugar) properly, leading to high glucose levels in your bloodstream. Your body might not produce any insulin at all, not enough, or your body is resistant to the insulin produced. Find out more about the different Types of Diabetes here.
I’ve just been diagnosed – what happens now?
When you are diagnosed as diabetic, your GP or Diabetologist will lead your overall care and management plan, ensuring that they thoroughly explain your diagnosis, what it means for you and how to make lifestyle changes (such as diet and exercise) to control your Diabetes as well as prescribing any medication and monitoring it regularly.
For those of us with Diabetes, it can be a steep learning curve, especially at the start when we are first diagnosed and it can be a frightening time.
There is lots of good news concerning Diabetes now – there have been tremendous advancements in healthcare in every area – in diagnosis, management and treatment plans. There is absolutely no reason not to expect to live a long, happy and healthy life if you keep your blood sugar levels in check.
Why do Diabetics need to see a Podiatrist?
Combined with your Diabetologist or GP leading your care, you should also see a Podiatrist and an Ophthalmologist at a minimum of once a year. This is because we (Podiatrists) deal in feet – the part of your body that is furthest from your heart and Ophthalmologists deal with one of the smallest, yet most visible organs – the eyes. These tow things matter because the furthest away (feet) and smallest (eyes) parts of your body will show up even the smallest changes in your condition the earliest. And this is good news because it means you and your Doctor can then make any changes to your routine or medication early to stop any more serious complications developing later in time to your more major organs such as heart or kidneys. So your eyes and feet act like an early warning symbol.
How Can Diabetes Affect Feet?
There are several ways Diabetes can affect the feet. However, its important to note that it isn’t at all inevitable that Diabetics will develop any complications. In fact, there is no reason not to remain healthy and happy with good self-management and blood sugar control. Your GP will advise you on diet, lifestyle and medication (if necessary) and will also refer to you to a nutritionist for diet advice.
If your Diabetes is chronically not well controlled, you may be at risk of damaging your sensation to your feet and legs (neuropathy) and the blood circulation to them (angiopathy).
What is Neuropathy?
Neuropathy is damage to your nerves. You may experience burning, stinging, pain or weakness in your feet if you are developing neuropathy – any people say that it feels like lots of bee or ant stings. It lessens your ability to feel – hot, cold, injuries.
If you are losing sensation in your feet, this means that you could injure your feet and not know it – standing on broken glass or a pin and not feeling it. Then the injury doesn’t get treated. If you also have reduced blood supply (angiopathy) then the wound can’t heal as fast or as well and can ultimately develop into an ulcer.
How does Nerve Damage Affect the Feet?
As well as injuries not being noticed or healing well, neuropathy can also affect your foot posture and shape, leading to increased pressure and weight on different areas of your foot, again causing injury over time as hard skin, blisters, corns and even ulcers then develop.
Nerves also control the sweat glands and oil secretion in your feet and legs, keeping your skin hydrated, elastic and with a natural protective ‘acid mantle’ layer that fights off bacterial and fungal infections. When nerves are damaged, the skin becomes dry, flaky and may crack and be more prone to infection (such as cracked heels).
Drier skin and changed foot posture due to damaged nerves can lead to callous or hard skin. Left untreated, it can build up causing eventual ulcers underneath.
Ulcers in diabetics most commonly form on the ball of your foot or on your toes – areas where a lot of your body weight falls, and where you might get friction from tight footwear.
What Can I Do to Help my Feet?
If you are Diabetic, make an appointment with your podiatrist as soon as you are diagnosed (even if you have no foot problems) and then every year thereafter, or as advised by your Podiatrist. She may want to see you more often in some cases.
• Take good care of your feet every day and inspect them daily (find out more about caring for your feet here).
• Be proactive about caring for yourself and managing your Diabetes – treatment works best when it is focused around you being in control – know your blood glucose / HbA1c levels every day.
• If you notice any changes in your overall health and wellbeing go straight to your Doctor – don’t delay.
• For even ‘minor’ injuries – a cut to your foot or an ingrowing toenail, see your Podiatrist straight away.
• See your Podiatrist for regular medical pedicures in between your diabetic foot assessments to maintain great foot care and especially if your mobility doesn’t allow you to reach your feet.
• Follow a healthy eating plan, with help from your Nutritionist. Why not include the rest of the family in spreading healthy eating habits?
What Can My Podiatrist Do to Help?
• We carry out foot health checks at least annually for our diabetic patients, sometimes more frequently for those more at risk.
• We discuss thoroughly with you your diagnosis, how to help care for your feet and how to prevent foot complications – ask us anything!
• We will address any biomechanical foot issue to alleviate too much pressure on one area of the foot, through padding or custom orthotics if needed.
• We provide you with your written diabetic foot report to take with you to your Doctor / Diabetologist for follow up. They will want to see our report and your Opthalmologist’s report to help them monitor management. Our tests and specialist foot report make up the jigsaw to best manage your overall care.
What does a Diabetic Foot Check Up Involve?
First of all, there is no pain and nothing to worry about. We carry out tests on your feet to assess your blood circulation (both arterial and venous – to and from the heart), sensations, skin and nail condition, footwear check and advice, biomechanical assessment (foot and leg posture) and more! Find out more about the check-ups here.
The main point is that we are here to help. Every single person is different, with different blood sugar readings, management, medication, overall health and so on. We’re all unique and the aim is to help finely tune your individual management.
We love questions and are here to have a friendly conversation – to put your (and your family’s) mind at rest. We will discuss all of the tests, all of our findings and talk about ways to keep your feet healthy for the next 10, 20 and 30 years and more.
Contact Dubai Podiatry Centre, the diabetic foot experts today, on +971 4 3435390.