Foot care is especially important for people with diabetes to prevent or eliminate problems. Regular foot care from a Health Professions Council Registered Podiatrist, is essential to keep a diabetic's feet in good order. Here at Trinity Podiatry Clinic we can help keep your feet healthy.
Diabetes mellitus is a disorder in which sugars in the body are not broken down to produce energy due to a lack of the pancreatic hormone “Insulin.” This disorder is characterised by an inability to reabsorb water, which results in an increased urine production, excessive thirst and excessive eating. The accumulation of this sugar leads to its appearance in the bloodstream (hyperglycaemia) and then in the urine. As this sugar cannot be broken down to produce energy, the body utilises its fat storage as an energy source. This alternative source of energy leads to disturbances of the acid base balance and accumulation of ketones (Ketosis) in the blood, this eventually leads to convulsions, which precede diabetic coma.
Diabetes, which starts in childhood or adolescence (juvenile-onset diabetes), is often more severe than when it begins in middle or old age (maturity-onset diabetes). There are 2 types of diabetes:Insulin dependent diabetes
In this condition patients have little or no ability to produce the hormone insulin and are entirely dependent on insulin injections for survival.Non-insulin dependent diabetes
Usually occurs after the age of 40. The pancreas retains some ability to produce insulin but it is inadequate for the body’s needs. Patients may require advice on diet or treatment with oral hypoglycaemic drugs.
With both types of diabetes, diet must be carefully controlled with adequate carbohydrates for the body’s needs. Lack of balance in the diet, or in the amount of insulin taken, leads to hypoglycaemia. This is a deficiency of glucose in the bloodstream causing muscular weakness, in-coordination, mental confusion and sweating, which may lead to hypoglycaemic coma. Long-term complications of diabetes include thickening of the arteries, which can affect the eyes. It is therefore important that the eyes are also checked regularly.
Diabetes is a disease with widespread complications throughout the body, and the feet are one of the main areas in which serious complications can occur.
- Neuropathy, this is damage to the peripheral nerves causing weakness and numbness. There is a danger that due to loss of protective sensation pressure sores and general damage to the skin may occur causing danger of infection. Neuropathy may improve with control of diabetes.
- Ischaemia, this is a vascular disease where there is inadequate flow of blood to a part caused by constriction of the blood vessels.
- Diabetes affects the nerves so that pain signals arising from the feet cannot reach the brain. The diabetic patient loses the warning signals produced by injury. Similarly, if the blood flow to the feet is limited or absent, then the ability of the body to fight infection is removed. This allows the infection to spread and a leg can become at risk from gangrene and amputation.
- At Trinity Podiatry Clinic we can perform tests that offer a reliable and efficient indication of whether a diabetic is likely to develop the diabetic foot syndrome called Peripheral Neuropathy.
- Peripheral Neuropathy, is a disease of the sensory nerves, which often results in the insidious development of painless ulceration and gangrene of the toes and feet.
- If you have been diagnosed as having diabetes then these tests are recommended every six months.
- As a diabetic you may experience a reduction in feeling, so other senses should be used, especially the eyes and hands, to detect the earliest signs of injury or infection. If these signs are neglected serious problems may develop.
- The diabetic should follow these simple rules:
- Wash feet daily in warm, not hot, water.
- Take care to remove debris from between the toes and dry the feet carefully and thoroughly.
- Apply moisturising cream to any dry areas.
- Examine the feet carefully after each wash for any signs of cracks, corns, blisters etc. If you find anything unusual, however small, come to the Clinic. If you cannot see the soles of your feet, sit on a bed or on the floor and view them through a large mirror. If your eyesight is poor, ask someone to examine them for you.
- Always dress in roomy, woolly socks - two pairs if necessary.
- If your circulation is poor, wear trousers and in cold weather, long johns.
- If you have had Neuropathy of the feet, and if you have them, always wear the special shoes that have been made for you. They will help you remain free of corns and calluses, and will protect your feet from injuries that you cannot feel, e.g. drawing pins or splinters in the sole of the feet etc.
- Never walk about barefoot in the house, and wear slippers when you get out of bed during the night.
- Check your footwear each time you put your shoes on, in case small objects have dropped into them.
- Do not sit too close to a fire as you may burn your legs without realising it.
- Take hot water bottles out of the bed before you get in, and wear bed-socks if necessary.
- Do not attempt to cut your own toe nails, and most certainly, do not under any circumstances use corn plasters, or any other form of substance which could damage your skin.
Come to the Trinity Podiatry Clinic regularly for routine nail trimming, callous removal and foot inspections.