Diabetic foot care

One of the problems that affect the quality of life for diabetics is problems with their feet. This happens because diabetes, if not well controlled or if under treated, can cause damage to the smaller blood vessels of the hands and feet.

The resulting poor circulation means the feet are more likely to recover slowly from any damage, such as blisters or wounds, resulting in sores and ulcers.  

Increased levels of sugar in the blood also mean infections are more likely and are harder to treat. As well as the nerve endings in the hands and feet being damaged by the increased sugar in the blood, the damage doesn’t cause the usual pain that non-diabetics would feel after an injury.

As a consequence, diabetics need to be vigilant about checking their feet to ensure that any damage is minimised and treated as soon as it occurs. If left untreated for lengthy periods of time surgery is needed to remove the infected or dead areas, particularly in the lower limbs.

Diabetics should have their feet checked by their doctor, nurse or pharmacist at least annually to ensure that their circulation, nerves and skin is in tip-top condition. They should also spend some time checking out their feet themselves at least each week, regularly, as part of their diabetes management plan.  

It is important to look at the skin on top of the feet, between the toes and on the soles of the feet. Placing a foot on a stool or chair brings the foot closer to the eyes, or you can inspect the feet while sitting down. The best time to examine your feet is after bathing or showering. Wash and dry them thoroughly, and use this time to spend about five minutes inspecting them.
To look at the soles of the feet place a hand mirror on the floor. You can then angle your feet over the mirror one at a time, rather than attempt any yoga moves that become more difficult past middle age as flexibility is reduced.

While you are checking out the feet, rub in some moisturising lotion and trim your nails carefully. After this, cover the feet with socks or slippers to ensure you don’t slip over and fall, causing further damage. If you notice callouses or corns then consult your pharmacist about suitable treatments that diabetics can safely use to prevent damage. If you need further treatment, then your community pharmacist can refer you to either your doctor or to a podiatrist to ensure your foot condition is managed to prevent or limit the risk of serious infections and damage requiring surgery or other invasive treatment.

While diabetics need to be particularly vigilant, all of us need to inspect our feet regularly to ensure they can continue to carry us about our lives as comfortably and painlessly as possible.