Diabetes and Podiatry

29 Oct 2023 | Conditions & Treatments, Diabetes

Podiatrist diabetic foot care is incredibly underrated! Let me tell you a little story to paint a picture…

It starts with poor glucose control

Imagine you have a grain of sand in your shoe. A person with normal nerve function and sensation will be able to feel the irritation and remove the grain of sand. But a person with diabetes may not be able to feel it. High blood sugar levels over an extended period can lead to nerve damage (neuropathy) and poor blood circulation.

If the grain of sand it there long enough, it is very likely to cause friction and eventually break through the skin, undoubtedly becoming infected. You still cannot feel, so you don’t know there is something happening under your foot. Poor blood flow exacerbates the infection and eventually things start to smell.

The worst complication

Your wife cannot figure out where the smell is coming from (she is moaning about it a lot). One evening you put your feet up at the end of the day and she walks past and notices a discoloured stain on your white sock, and the origin of the smell! By this stage it is no longer a small break in the skin from a grain of sand. It is a large and messy wound about the size of a R5 coin, with spreading redness (infection), and the foot starting to look nasty.

There are a few versions of what happens next depending on who you go to for help and how bad the situation is, but either way, one of the things that will be discussed is amputation. Chopping off your foot! Diabetes is the leading cause of non-traumatic lower limb amputations. The 5 year mortality rate after amputation is 68%.

There is hope

Amputation can be prevented! If you are living with diabetes regular appointments with a podiatrist are so important. They will do a foot screening and categorise your risk of developing an ulcer, which will dictate how often you see them and what interventions to put in place. For example:

Low risk of complications: very good glucose control, no foot deformities or problems, you can reach and cut your own toenails = podiatry check-up once a year

High risk of complications: poor sensation and/or blood flow, callus under the feet from excessive pressure, thick and difficult toenail that you cannot cut yourself = podiatry appointment every 6-12 weeks for looking after skin and toenails as well as other interventions like footwear and custom foot orthoses to manage the pressure to prevent ulceration.

 

Prevention is better than a cure but podiatrist are also equipped to manage complications like infected ingrown toenail and ulcers.  Podiatrists work closely with wound care specialist nurses to close wounds and then the aim is to keep them closed.

 

As you can see, taking care of your feet is a crucial part of managing diabetes. By being aware of potential complications and seeking professional care, you can maintain good foot health and enjoy excellent quality of life.

To book an appointment with one of our podiatrists, click here to send a whatsapp to reception

 

For more information and statistics on diabetic foot health, have a look through these 2 websites.

Diabetic Foot Online

Diabetes Atlas