THA LIFESTYLE | HEALTH & WELL BEING
THE DIABETIC FOOT
D
iabetes is a common
condition affecting millions
of people around the world
and this disease costs lives and
irreversible complications.It is a
lifelong condition caused by high
levels of glucose (sugar) as the
body fails to use it properly.
The pancreas produces insulin,
a hormone to help the glucose
enter the cells in our body and to
be used as energy so that we are
able to lead a normal life. However,
in a diabetic the pancreas fails to
work properly.
Diabetes is classed as Type 1 and
Type 2. In a Type 1 diabetic the
pancreas is not producing any
insulin and in a Type 2 there isn’t
enough insulin being produced, or
the insulin being produced isn’t
working properly and therefore
the glucose entering the cells
is reduced or absent. This
abnormality causes long term and
short term complications which
can affect the body in many ways
including the heart, eyes, kidney,
the nerves and the feet.
The nerves in the body of a
diabetic are often affected as the
blood vessels which supply the
nerves can be damaged due to the
high blood glucose. This reduction,
or the loss of sensation in one’s
feet can lead to the individual not
being able to feel any trauma to
the foot. A diabetic who presents
with a reduced neurological foot
may stand on a sharp object and
fail to feel it.
This may then develop into a
wound, which may or may not heal
depending on the blood supply
to the affected area. The chance
of getting an infection is also a
great risk to a diabetic and they
may go on to need long term ulcer
wound care management, lifestyle
changes, surgical procedures or
even amputation.
A Podiatrist’s advice
foot check then any signs
of discolouration or altered
sensation should be assessed by
your podiatrist or your general
practitioner as soon as possible
so that the correct advice can be
given and further complications
can be prevented.
Not all diabetics develop
Senior Podiatrist Vinusha who works for the National Health
Service for 12 years shares some key facts in this article
which may help prevent any diabetic foot complications
As with any person, diabetic or
not, a diet high in fats and those
who smoke significantly increase
their chances of their arteries
becoming narrowed. It is vital that
a diabetic person adapts a healthy
lifestyle such as exercising more,
reducing weight and maintaining a
well balanced diet to help prevent
complications such as ulcers in the
future.
It’s easy. Simple steps are
required. Be well informed of what
is happening to your feet. What
can you feel and what can’t you?
Do you have circulation problems
or not? Ask your podiatrist or your
practice nurse at your GP surgery
to carry out an annual diabetic
foot check. An annual foot check
will involve painless neurological
assessment requiring you to tell
them whether you can feel a 10g
monofilament, a sharp and blunt
neurotip, a tuning fork and cotton
wool to different areas on your
foot.
A vascular assessment will also
be carried out and a doppler will
be used to listen to your pulses
and the systolic pressures will be
obtained to determine whether
there is arterial disease. The
diabetic foot assessment will also
include a general foot check to
look at the general health and
the viability of the skin and any
abnormalities, which may require
attention.
If you are however, unable to
attend a clinic for a diabetic
complications, however if there
are complications such as reduced
sensation in your feet or narrowing
of the arteries then it is vital that
the correct steps are taken to
prevent further complications,
which may lead to amputation.
It’s very crucial to know the
importance of good foot health if
you are a diabetic. Prevention and
protection are key elements to
maintaining good foot health in the
presence of diabetes.
The chances of an ulcer developing
when you are a diabetic are
greater and simple preventive
steps can be taken;
* Not allowing bare feet to come
into contact with the ground will
significantly protect them from
damage so wear slippers around
the house,
* Creaming your feet as dry skin
cracks easily.
* Check your feet daily to prevent
further problems.
* Try not to cut your nails too short.
* Don’t pick your skin, callous or
corns.
* Don’t use sharp instruments in
self-care.
* Don’t use medicated ointments or
corn/callous removal pads.
Picture this. If you have numb
feet you may fail to feel an injury
and this allows microorganisms to
enter the injured site and cause
an infection. Without adequate
blood supply to the injured area,
healing may be delayed or not
be possible. The longer a wound
stays unprotected or untreated
the less chance of it healing and
this may cause tissue death, which
is also known as gangrene. This
may need surgical debridement
or amputation to prevent further
infection or to minimise further
tissue and bone complications.
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