Diabetes gives rise to a host of different conditions—some more difficult to treat than others. Autonomed gives readers advice on diabetes and foot care
1. What are the common problems associated with diabetes and foot care?
Diabetes is a lifelong condition which causes foot problems in lots of the affected population. Many of these problems occur because the nerves and blood vessels supplying your feet get damaged by diabetes, affecting the feeling in the feet (peripheral neuropathy) and the circulation in the feet (ischaemia). These changes can be very gradual and may go unnoticed. Neuropathy can also cause a change in the shape of the foot resulting in areas of high contact pressure, leading to hard skin which puts the foot at increased risk of skin breakdown/ulceration. Any of these are classic warning signs to be extra vigilant
2. As a diabetic, how can I reduce the risk of foot ulceration?
Be vigilant! Check your feet daily (tops & soles) for changes—especially for any breaks in the skin, cuts, blisters, hard skin build up (callus), a change in the colour of the skin, increased temperature or fluid leaking from an area of the foot which may be a sign of infection. When checking your feet, if you notice any of these seek advice from your podiatrist, practice nurse or GP right away.
Make sure you receive an annual diabetic foot screening which can be carried out by any trained healthcare worker but most often by a podiatrist a nurse or a doctor. Make sure your shoes fit correctly and always be careful when wearing new shoes, check for signs of irritation or damage to your feet.
See also: Foot Ulcers in Diabetes
3. There are many products on the market that claim to help diabetes and foot care; what factors should I consider when choosing a product for myself?
Like any speciality, the diabetes market unfortunately has no shortage of claimed 'miracle' cures, so the first thing is to check any product been formally clinically trialed to support any claims. If it’s used by the NHS or issued on NHS prescription, that immediately confirms it does what it says on the tin. With the two main causes of ulcers being uneven, high pressures on areas of the soles of the feet combined with poor circulation, a product such as Liqua Care which reduces these pressures and increases the circulation will significantly improve your chances of avoiding problems.
4. How could I tell if I do have an infection or ulcer on my feet?
An ulcer on your foot will usually leak fluid which you may notice on your sock or stocking. The signs that an ulcer has become infected can range from the skin surrounding the ulcer becoming red and inflamed, the foot becoming warmer and as mentioned before fluid or pus leaking from the ulcer. The number one rule is again to check your feet daily which will enable you to spot any problems quickly and seek help/advice. The use of a mirror to check the soles of your feet can be very helpful and if you see anything 'different' then get medical advice quickly. Remember that if you have neuropathy then you won’t feel the pain from a wound.
5. Who is more likely at risk of developing foot ulcers?
There are specific 'risk factors'. A few have been mentioned—neuropathy, poor circulation, dry hard skin, callus, change of shape of the foot/feet—any of these puts you at risk. Following your annual foot screening you should be informed of your risk of developing a diabetic foot ulcer by the person carrying out the foot screening. Remember: anyone who has previously had a foot ulcer has a 50/50 chance of re-ulcerating within a year.
6. How are diabetic foot ulcers formed and how can they be treated?
An ulcer is just another word for a break in the skin or a wound that won’t heal. This means that any break in the skin, cuts or blisters, can turn into an ulcer. Treatment varies based on the nature of the ulcer/ wound and will usually be carried out by a diabetes specialist podiatrist where a lot of different factors will be addressed including treating infection, relieving the pressure from the affected area and having a suitable dressing in place. This can take a long time and many clinicians believe an ulcer is never healed—it only goes into remission and has therefore a high chance of recurring.
See also: Diabetes: Prevention and Treatment
7. What tips can you give on diabetes and foot care?
Prevention is the absolute key. Make sure your shoes fit correctly, check your feet daily, never go barefoot, attend your annual foot screening. Consider products that will even out the pressures on the sole of the foot and help with the circulation.
8. How can I monitor the progression and development of diabetic complications in feet?
Diabetic foot complications can develop gradually and can initially go unnoticed. Attending your annual foot screening, having the person who carries out your foot screening informing you of your risk of developing a foot ulcer and listening to their advice is crucial. You only get one pair of feet so look after them—prevention is better than cure!
Our thanks to Autonomed for their assistance with this article on diabetes and foot care.
If you want to read more on Celebrity Angels about how to manage diabetes for better foot health, click here.