Diabetes Foot Care

Diabetes results from a persistently raised blood glucose level. This can be a result of either reduced production of or increased cell resistance to the hormone insulin.
Type 1 diabetes results from damage to the insulin producing pancreatic cells often as a result of a virus in early age. Typical symptoms include persistent thirst, increased urination and weight loss.
Type 2 diabetes results from a decreased ability of the body’s cells to use insulin often as a result of obesity. Patients often complain of only one of the classic symptoms and are diagnosed more as a result of a sepsis or ulceration of the feet.

Persistent high blood glucose levels (hyperglycaemia) can cause permanent glycation of the vessels of the body. This can result in damage to the nervous system (Diabetic Peripheral Neuropathy), the cardio-vascular system (poor circulation), the kidneys and the eyes.

 

Diabetic peripheral neuropathy:

Diabetic neuropathy deserves special mention as it is the most common type and can lead to serious complications in those with diabetes. Diabetic peripheral neuropathy indicates damage to nerve fibres.The process by which the nerves are damaged is not entirely clear but it is probably related to high blood glucose that affect the metabolism of nerve cells.

There are three types of diabetic peripheral neuropathy:

  • Sensory (loss of ability to detect sensations such as heat, cold, pain)
  • Motor (loss of abilty to control movement)
  • Autonomic (regulate functions such as heart rate and digestion.

Symptoms can include pain and burning leading to further discomfort (painful neuropathy).

Protection of the foot in peripheral neuropathy

Loss of sensation (numbness) is common in peripheral neuropathy. Damage to the foot can go undetected and lead to serious complications. It is best to protect the foot with good fitting foot wear and the foot should be inspected daily for damage. Particular attention should be paid to corns and callus (Hyperkeratosis), as these may need treatment by a podiatrist.

Poor circulation

Diabetes often leads to peripheral vascular disease that inhibits a person’s blood circulation.  Poor circulation contributes to diabetic foot problems by reducing the amount of oxygen and nutrition supplied to the skin and other tissue, causing injuries to heal slowly.This  can lead to ulcers, infection, and other serious foot conditions.

Ulceration
Ulceration is described as a chronic wound where tissue has not healed.Initial causes are wide ranging. Impaired blood supply or drainage, hormonal disorders, persistent mechanical stress or combinations of all these are instrumental in wound formation and impaired healing.
Podiatry consultation is required to establish the cause, the type of wound and measure diameter and depth. Photographs may be taken for future comparison and swabs taken to identify any infection.

Diabetic Foot Assessment