YOUR HEALTH
with Dr. Thakkar
DON’T TRIP OVER YOUR FEET
Diabetes and diabetic foot disease is a common and potentially devastating
problem. Furthermore, a huge number of people are diabetic but don’t
realise it, which is why the NHS health check programme is so important.
So, what are the complications of diabetes?
They can be broadly split into two types,
microvascular and macrovascular.
Microvascular complications include eye
disease, kidney disease and nerve damage.
Nerve damage is particularly relevant to the
diabetic foot. Remember what it’s like to
have a stone in your shoe? If you can’t feel
that stone, as you walk it will damage and
eventually break through the skin, creating
an ulcer. Even a small wound can develop
into an ulcer. The ulcer may get infected.
Eventually the infection may penetrate in to
the bone which is a nightmare to treat. Nerve
damage, which is common in diabetes, can
also cause deformity of the bone, known as
Charcot’s foot.
Macrovascular disease causes furring up of
the arteries, stroke, heart disease and poor
blood supply to the limbs. Without a good
blood supply, the foot is prone to gangrene
and infection.
The presence of micro or macrovascular
disease puts the diabetic at significant risk of
limb amputation and, unfortunately, this is all
too common a scenario in Buckinghamshire.
How can you reduce the risk of foot
complications and, in particular, infections
and amputations?
Prevention is essential, and that means
weight control, exercise, good diet and
avoiding smoking. The heavier you are, the
more likely you are to develop diabetes and
its complications. Exercise helps to reduce fat
around the pancreas too. Smoking increases
the risk of macrovascular disease.
Early diagnosis of any disease means it can
be managed more effectively. Diabetes is no
exception. Symptoms of diabetes include
weight loss, fatigue, thirst and passing
excessive amounts of urine. Many diabetics,
however, have no symptoms, so if you’ve
been invited for an NHS health check, please
do attend.
Once you’ve been diagnosed with diabetes
looking after your own health is absolutely
critical. That means a low sugar diet, regular
exercise, stopping smoking and controlling
your weight. Taking your medication as
prescribed is needed to control blood
pressure, blood glucose and cholesterol.
Checking your shoes for stones, attending
regular diabetes clinic appointments and
education sessions, and checking your feet
for corns and calluses, wounds, grazes, cuts
and infections are all required to reduce the
risk of complications. This includes checking
soles of your feet. For more information
please see your doctor or see
www.diabetes.co.uk/diabetes-
footcare.html.
Like most of my articles, good care requires
the people of Buckinghamshire to take part in
improving the health of our county.
Dr. Thakkar is a GP at
Pound House Surgery
Chiltern Clinical
Commissioning Group
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