People with diabetes have to look after their feet because diabetes can cause poor circulation and loss of sensation in the feet. As a result of poor circulation, wounds and cuts will take long to heal and can lead to infection. Furthermore, diabetes can cause loss of sensation (peripheral neuropathy), which you may not be aware of that you have a wound or an ulcer until a later stage by which time it may have become infected. Therefore it is very important for you to have daily checks on your feet and most importantly visit a HPC Registered Podiatrist for regular checkups and treatment. Why?
- Because the Podiatrist will check your circulation
- The Podiatrist will assess your foot sensation and categorise you as low risk, high risk or increased risk. This is done by assessing your pulses and sensation tests.
- Looking at skin tone
- Atrophic (thin skin)
- Anhydrotic (dry skin)
- Colour of skin (pale, cyanotic)
- Advice on nail care (how to avoid cuts and ingrown toe nails)
- Check for foot deformities eg; hammer toes, bunions and give you appropriate advice for footwear to prevent chaffing at pressure points; corns calluses.
- Look at your foot wear to see if there is excessive wear by looking for seams insides the shoes, which can cause abrasions in the skin that can lead to potential problems such as, blistering.
The podiatrist will check your hosiery to ensure it is not tight that it reduces your circulation. To look for seams that can cause problems.
- To prescribe orthotics (arch supports/insoles) that will help reduce pressure and redistribute the pressure more evenly, to prevent ulceration.
- To check for corns and calluses and treat them appropriately (patient should avoid using off the shelf products).
- To encourage foot and leg exercises to maintain circulation.
- If you have dry skin; apply creams to stop the skin from cracking.
Daily Checks/Warning Signs
Check your feet daily for cuts, bruises and any other damage.
If there is any redness in any part of the foot or leg or if they feel hot then this may indicate infection/inflammation especially if there is a cut or open wound. Remember, this needs prompt attention since awareness of pain maybe diminished, therefore consult a Podiatrist (Find your nearest Podiatrist here) or seek medical help urgently.
NB: If you have the following:
- Break in the skin
- There is a discharge
- If the skin changes colour i.e becoming red, blue, black or pale
- If you see black spots under the calluses or corn
…you should see a podiatrist, this is because there is excessive pressure that will cause tissue breakdown and if this is left untreated it will be likely to cause an ulcer and therefore you will need to see a Podiatrist to offload this pressure.
What happens when you get an Ulcer?
Firstly, the podiatrist will assess the cause of the ulcer, the blood supply and check your footwear. Then subject to your blood supply, the removal of the calluses and dead tissue may be necessary. If infection is present, the podiatrist will organise antibiotic to cover the infection. The ulcer will be dressed with sterile dressing and appropriate padding to redistribute the pressure, to help speed up the healing process. Furthermore, on assessment if a bone infection is suspected an x-ray will be appointed. A referral for specialist footwear will also have to be organised to prevent future ulceration.