The Diabetic Foot: Diabetes is becoming more common in the world, especially the western world and it is thought this is due to lack of exercise and poor diet. Many people have diabetes and do not even know they have it. The feet of people with diabetes, mainly if it is rather uncontrolled could be affected by: • An increased risk of infections within the feet (that can lead to systemic infections). • Peripheral Neuropathy (irreversible numbness within the feet which can become as widespread as a glove and stocking distribution). • Peripheral Vascular disease (lack of blood supply to the hands and feet). Infection, lack of blood supply and feeling are a recipe for disaster and can lead to Diabetic Foot Ulcers (see attached picture). Ulcers than do not heal can lead to foot and leg amputations due to infection of bone and inability to heal. Diabetes can also cause a condition called ‘Charcot Neuro-Arthropathy.’ This is a horrible condition whereby the foot becomes numb and therefore the body (brain) starts to believe there is no pressure or body weight going through the feet (even when there is). In response to this it thinks the bones do not need to be as strong and so the bones become weaker. At this stage, just simple body weight can cause the bones to fracture / stress fracture, leading to deformity and changes to the joints of the foot. Sadly this causes high areas of pressure which become prone to ulceration (especially with a lack of feeling). ** If you are or know someone with diabetes who has numb feet, that suddenly become painful, very warm and very swollen (sometimes called elephant foot) – they need URGENT medical care ** Unsurprisingly those who suffer the complications of diabetes within the feet have; poorer quality of life, restriction in the ability to get around, more systemic illness and decrease life expectancy. Van Baal (2010) suggested those with ulcers or Charcot Neuroathropathy lose approximately 14 years of their life! It is not all doom and gloom though! If you control your blood sugar levels the risks of these happening are much reduced. It has been recommended by NICE (the national institute of clinical evidence) since 2011 - that all diabetes should have free access to annual foot screening. This can be done by a podiatrist of diabetes specialist nurse / consultant. ORTHOPODICS CAN DO THIS SCREENING FOR YOU AND PRODUCE A REPORT FOR YOU + YOUR GP. THIS REPORT WILL IDENTIFY RISK FACTORS FOR FOOT PROBLEMS AND HOW YOU CAN REDUCE THEM. Check out orthopodics.co.uk to find out more. NICE 2011 also recommends that those who go onto developing diabetes foot problems should have access to a Multi-Disciplinary Team. Those in the team should include a diabetes specialist podiatrist, tissue viability specialist nurse / podiatrist, a diabetes consultant and an orthopaedic consultant specialising in diabetes. It is believed that this can lead to a 40-80% reduction in the risk of diabetes foot amputation. Take home message is simple this week. If you have Diabetes – control your blood sugar levels! If you do not have diabetes but are thirsty a lot of the time or have frequent need to urinate then get a test by your GP or local pharmacy (or friend with a machine). This is more imperative if there is a family history of the condition. Diabetes can also lead to Retinopathy (eye problems), Nephropathy (kidney problems) and Coronary Heart Disease (strokes / heart attacks) so you would be an idiot to ignore it!
Posted on: Mon, 29 Jul 2013 21:37:23 +0000
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