Preventing and managing diabetic foot complications
Diabetes is a complex and progressive condition that can affect many parts of your body, including your feet. Podiatrists are one of the essential professions within diabetic care and have an important role to play in preventing and managing foot complications amongst people with diabetes. It is crucial that people with diabetes understand the cause of these risks and their current risk status to minimise complications.
It is advised to have an assessment of your feet after being diagnosed to ascertain your foot health status and so we may provide advice that helps you improve and maintain the health of your feet. Annual check-ups can then help to monitor progress and guide you in self-care.
Self-care of feet is particularly important for people with diabetes. It is recommended that you inspect your feet daily, looking at each foot for signs of injury including blisters, bruises, cracked or broken skin, swelling, cold or hot areas, corns and calluses, and discolouration.
Identifying any injuries early can mean the difference between a minor treatable condition and something that can become limb threatening.
A neurological assessment involves:
- The use of a monofilament which checks for the level of protective sensation intact. This is an important indicator of your risk of diabetes related foot complications.
- The use of a neurothesiometer or a tuning fork to evaluate the response to vibration. This is usually the first marker of neuropathic change and may be accompanied by neuropathic symptoms.
- Other assessments, if indicated, will include reflex check, proprioception, and sharp/blunt detection.
How diabetes can affect your feet?
- Diabetes can cause nerve damage (numbness, burning, tingling or pins/needles) within your feet known as peripheral neuropathy. This reduced nerve sensitivity can lead to unnoticed injuries.
- Diabetes can restrict the circulation to the feet known as peripheral vascular disease (PVD). Poor blood flow means that your body’s normal response to healing is reduced and cramps in the feet and lower limbs are more common.
- People with diabetes are more prone to foot infections such as cellulitis and tinea.
- Diabetes can affect joints, muscles, tendons, and ligaments causing them to change making them stiffer.
- Diabetes complications can lead to an increased risk of foot ulcers and amputation
A vascular assessment to assess the circulation in your feet involves:
- Palpation of the pulses of your feet or with the use of the Bi-directional Doppler 30EX to assess the rate and magnitude of flow
- Toe Brachial Index (TBI) is performed to assist in assessing microvascular flow or when required, an Ankle Brachial Index (ABI) to assist in assessng macrovascular flow.
- Visual assessment of skin integrity, hair growth, oedema, varicosities as well as other markers of peripheral vascular health.
Backed up with experience
At Ashmore Podiatry, our team of podiatrists take a special interest in diabetes and can offer extensive education. They are highly trained and skilled to provide comprehensive assessments of your current foot health that entail a series of non-invasive vascular and neurological tests and furthermore, assess foot structure, loading patterns, footwear, footcare and muscular and proprioceptive status. The assessment is performed to determine the presence of risk factors for more serious complications to develop. Depending on the level of risk, these assessments can be carried out every three, six or 12 months.
We will then be able to provide you with an individualised management plan based upon our findings and your results are communicated back to your GP and healthcare team.
You can be assured that we use the highest quality equipment, backed up with the experience to accurately interpret the results.
Due to an increased risk of foot complications alongside a potential for poor vision and/or a decrease in flexibility, patients with diabetes are advised to have their toenails cut by a podiatrist. Here at Ashmore Podiatry, we understand that diabetic footcare is an integral part of ensuring foot and lower limb health.