Diabetes is a chronic condition affecting millions globally. While many people recognize its impact on blood sugar levels and general health, the effects of diabetes on foot health are often neglected. At our podiatry clinic, we emphasize the importance of educating our patients about the connection between diabetes and foot care.
In this blog post, we will explore how diabetes can affect the feet and discuss the importance of regular foot care and screenings for individuals living with diabetes.
Nerve Damage
(Peripheral Neuropathy)
One of the most serious complications of diabetes is neuropathy, a condition that affects the nerves and their sensations. Prolonged high blood sugar levels can damage the delicate nerve fibres that transmit sensory information. Consequently, individuals with diabetes may experience a loss of sensation in their feet, known as peripheral neuropathy.
This loss of sensation is particularly concerning as it makes it difficult to detect injuries or wounds. Patients might not notice blisters, cuts, or sores, leading to these issues going unnoticed and untreated. Additionally, the lack of sensation can alter the perception of pressure, increasing the likelihood of developing calluses or ulcers due to excessive pressure or friction on certain areas of the feet.
Reduced Blood Flow (Peripheral Artery Disease)
Diabetes can also affect the blood vessels, leading to reduced blood flow to the extremities, a condition known as peripheral artery disease (PAD). Elevated blood sugar levels can cause blood vessels to narrow and stiffen, restricting the flow of oxygen-rich blood to the feet.
When foot tissues do not receive sufficient oxygen and nutrients, they become more vulnerable to damage and heal more slowly. Even minor cuts or wounds may take longer to heal, raising the risk of infections. Poor blood flow can also result in cold feet, cramping, and pain, particularly during physical activity.
Combination of Neuropathy and Peripheral Arterial Disease
The combination of neuropathy and peripheral artery disease can create a concerning situation. Without the ability to feel pain or notice injuries, patients may unknowingly continue to put pressure on compromised areas, worsening the issue. Additionally, reduced blood flow impairs the body's natural healing process, resulting in chronic wounds and a greater risk of developing ulcers and infections.
Diabetic Foot Assessment
People with diabetes are generally advised (dependant on the extent of their condition) to visit a podiatrist at least once a year for a comprehensive diabetic foot assessment. This assessment includes evaluating the nerve function and blood circulation in the feet.
Neurological Examination:
The podiatrist will conduct a thorough neurological examination using standardised tests to assess the patient's sensory perceptions. This helps determine if there has been any loss of sensation in the feet (peripheral neuropathy), which is important for the patient to know. Loss of sensation can result in being unaware of stepping on sharp objects or increased risk of losing balance and falling.
Vascular Assessment:
The podiatrist will evaluate the patient's vascular health by palpating peripheral pulses, assessing capillary refill times, and, most importantly, using a Doppler ultrasound to identify any blood flow abnormalities in the feet that may require further investigation, such as Peripheral Artery Disease.
These assessments will be conducted alongside a comprehensive medical history review and a dermatological examination to identify potential issues, provide appropriate interventions, and educate the patient on preventative measures.
If you or someone you know has diabetes, yearly diabetic foot assessments are essential for maintaining optimal foot health and reducing the risk of serious complications. Remember, prevention is key when it comes to diabetic foot care.
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