Diabetes is a chronic condition that affects millions of people worldwide. While most individuals are aware of the impact it can have on blood sugar control and overall health, the effects of diabetes on the feet are often overlooked. As a podiatry clinic, we understand the importance of educating our patients about the relationship between diabetes and foot health.
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.
One of the most significant complications of diabetes is neuropathy, a condition that affects the nerves. High blood sugar levels over time can damage the delicate nerve fibres responsible for transmitting sensory information. As a result, individuals with diabetes may experience a loss of sensation in their feet, a condition known as peripheral neuropathy.
The loss of sensation in the feet can be particularly concerning as it can make it challenging to detect injuries or wounds. Patients may not notice blisters, cuts, or sores, which can go unnoticed and untreated. The lack of sensation can also lead to an altered perception of pressure, making it more likely for individuals to develop calluses or ulcers due to excessive pressure or friction on certain areas of the feet.
Reduced Blood Flow (Peripheral Artery Disease)
Diabetes can also impact the blood vessels, resulting in reduced blood flow to the extremities, a condition known as peripheral artery disease (PAD). High blood sugar levels can cause the blood vessels to become narrowed and stiff, limiting the flow of oxygen-rich blood to the feet.
When the tissues in the feet do not receive adequate oxygen and nutrients from blood, they become more susceptible to damage and slower to heal. Even minor cuts or wounds may take longer to heal, increasing the risk of infections. Poor blood flow can also lead to the development of cold feet, cramping, and pain, especially during physical activity.
Combination of Neuropathy and Peripheral Arterial Disease
The combination of neuropathy and peripheral artery disease creates a dangerous scenario. Without the ability to feel pain or notice injuries, patients may continue to put pressure on compromised areas, exacerbating the problem. The lack of blood flow can then impede the body's natural healing process, resulting in chronic wounds and an increased risk of developing ulcers and infections.
Diabetic Foot Assessment
It is generally recommended that people with diabetes visit a Podiatrist at least once a year for a full diabetic foot assessment, which will include assessing the nerve function and blood circulation in your feet.
Neurological Examination: The podiatrist will perform a thorough neurological examination using standardised tests to evaluate the patient's sensory perceptions. This will help us determine if there has been any loss of sensation in the feet (peripheral neuropathy) that the patient should be aware of as a loss of sensation can result in the patient being unaware of stepping on sharp objects or easily lose balance and be at a higher risk of falling.
Vascular Assessment: The podiatrist will assess the patient's vascular state through palpation of peripheral pulses, evaluating capillary refill times and most importantly, using a Doppler ultrasound to determine if there are any blood flow abnormalities to the feet that require further investigation such as Peripheral Artery Disease.
These will be done in conjunction with a thorough medical history and dermatological investigation to determine potential issues, provide interventions and educate the patient on preventative measures.