Diabetes and the feet
What is Diabetes?
Diabetes, or otherwise called Diabetes Mellitus, is a metabolic disorder characterized by high concentration of glucose in the blood (hyperglycaemia). This disease occurs when:
- The body is unable to produce a hormone called insulin, which regulates blood glucose levels (Type 1 Diabetes) or
- The body does not effectively use the above hormone (Type 2 Diabetes)
Type 2 Diabetes is the most common type of Diabetes. In Cyprus, it is estimated that more than 10% of the population suffers from Diabetes.
How is Diabetes diagnosed?
Diabetes is diagnosed using the fasting blood glucose test and oral glucose tolerance test. In a healthy person, normal fasting glucose values should not exceed 100mg/dl.
If you are in a prediabetic stage, lifestyle changes (weight loss, healthy diet and exercise) can help prevent the disease.
Am I at risk for Diabetes? Who are more likely to get it?
All adults over 42 years of age should check blood sugar levels at least once a year. People with a family history of diabetes in the family, obese people, women who developed gestational diabetes, women with polycystic ovary syndrome and those with high blood lipid levels (cholesterol, triglycerides) should often be checked for diabetes.
What are the symptoms of Diabetes?
Diabetes is often not accompanied by symptoms until a person reaches high levels of blood sugar. However, if any symptoms occur, they will include:
- Increased passing of urine (polyuria)
- Increased feeling of thirst (polydipsia)
- Sudden weight loss
- Blurred vision
- Slowly healing or non healing wounds
It is notable that for every three patients who know they have diabetes, another 2 do not know they do.
What are the complications of Diabetes?
Diabetes is a chronic disease which can lead to various complications as time progresses.
Peripheral neuropathy and vascular disease are the major complications of diabetes that can affect the feet.
Diabetes can cause loss of sensation in the feet and reduced blood circulation, so a patient may be experiencing a foot problem without realizing it (e.g. wounds that do not heal).
What can I do in order to protect and care for my feet?
Foot checks are very important for people with diabetes and should not be neglected. Diabetic foot checks should be done at least once a year and annually. If your doctor or podiatrist sees it necessary, then foot checks should be done more often. There is a specific diabetic foot assessment for the diabetic feet.
A very important part of care and prevention is up to patients. Remember the following:
- Inspect your feet daily - Look for cracks in the skin, wounds, any change in the skin’s colour or quality, swelling or very "hot" spots. If you are unable to check your feet yourself, ask someone to help you or use a mirror.
- Wear appropriate footwear - Choose shoes that offer support to the feet and are the right size, not too tight. Always ask for your foot size to be prior to purchasing any shoes.
- Never walk barefoot - There is a risk of injuring your feet without realizing it, so you must always wear shoes, even at home.
- Do not sit too closely to heat sources, such as fireplaces and heaters. This could be a danger of burning yourself without feeling it.
- Take care of your skin - Dry skin can easily crack and create wounds that are difficult to heal and openings in the skin that might get infected. Use a diabetic-friendly moisturizing cream and dry your feet thoroughly after showering.
- Seek professional help for your hard skin - Do not try removing hard skin with sharp objects yourself and do not use corn plasters, as they contain caustic ingredients that may cause a major problem to your foot.
- Keep your blood sugar levels under control and steady - This reduces the risk of complications such as peripheral neuropathy and vascular disease.
- Visit a podiatrist - Do not forget the annual diabetic foot check and contact a podiatrist if you notice any problems or abrasions on your feet. This foot check will indicate whether you have reduced sensation in the feet, so knowing that your sensation has been altered, you will be more careful when checking your feet.
What can a podiatrist do for people with Diabetes?
Among others, a podiatrist will:
- Check the status of your feet by performing a diabetic foot check, which will indicate both the level of blood supply to your feet, and if there is sensation loss in your feet.
- Look for any deformities or excessive pressure points on the feet. In this case, he or she will advise you on how to choose appropriate footwear and whether an orthotic insole is necessary.
- Help you keep your nails and callous under control, safely.
- Help in the management of open wounds - ulcers on the feet.
Early treatment of complications in diabetic feet (e.g. ulcers) can help prevent more serious complications of diabetes in the feet, such as severe infections and amputations.
(Reference: http://podiatry.org.cy/index.php/en/diabetes-and-feet )
(tags: podiatros, podologos, paralimni, ποδίατρος, ποδολόγος, παραλίμνι)