Diabetes is a chronic medical condition caused by a lack or shortage of insulin production by the human body. A shortage of this hormone results in an increase in the concentration of sugar in the blood, which is referred to as hyperglycemia. The more sugar tends to accumulate in the blood, the greater the danger of complications. The nerves and blood vessels of the extremities, such as the feet, are most often affected.
As a result, the diabetic foot is one of the most often recurring disorders for diabetics. Indeed, in the management of diabetes, great attention must be paid to the feet.
The term diabetic foot refers to a complication of diabetes that consists of a variety of foot injuries resulting from degeneration of the cardiovascular and nervous systems, which can lead to deterioration of lower extremity functionality. It is estimated that 15% of diabetic patients are at risk of developing foot injuries during their lifetime, which may require specific medical treatment.
SIGNS AND SYMPTOMS OF DIABETIC FOOT:
– Dryness, cracks and calluses
– Poor healing and scarring of the skin
– More common infections at the site of injury
– Ulceration of the foot
– Appearance of diabetes-specific wounds
– Loss of pilosity
– Cold or pale feet
– Numbness, tingling, unusual sensations under the feet
– Loss of feeling in the toes and/or foot
– Burning sensation in the feet, especially at night
– Deformities (hammertoes, bunions, more arched feet)
– Problems with balance and stability
WHAT CAN BE DONE TO PREVENT DIABETIC FOOT COMPLICATIONS?
Early diagnosis of the diabetic foot helps prevent complications of the disease. Good blood sugar control is the first step to a healthy diabetic foot. High or uncontrolled blood sugar levels can cause lasting injury to the nerves and blood vessels in the foot. In order to control blood sugar levels, attention must be paid to diet and physical activity.
HERE IS AN OVERVIEW OF HABITS TO INCORPORATE INTO YOUR DAILY LIFE:
– Never walk around barefoot;
– Wash your feet daily with a mild soap, then dry them well;
– Apply a moisturizer every day, as dry feet are more prone to cracks and sores;
– File your toenails well to keep them short, using a nail file. It is best to avoid scissors and nail clippers, as the risk of injury is too high;
– Frequently remove calluses (areas where the skin thickens and hardens) with a pumice stone;
– Examine feet daily for sores and injuries as soon as possible;
– Disinfect wounds and examine them periodically for early signs of infection (redness, warmth, swelling, localized pain, discharge). If these signs are present, consult a doctor or podiatrist without delay;
– Wear shoes that fit the width and shape of your feet and make sure they are comfortable;
– Always check the inside of your shoes before wearing them to remove any objects that could hurt you.
WHY CONSULT WITH YOUR PODIATRIST?
Diabetic foot care is recommended from 1 to 12 times a year depending on the patient’s health and foot condition. They allow us to monitor the evolution of their condition in order to prevent and intervene quickly in case of diabetic foot complications.
Callus cleaning helps prevent the formation of pressure points that can lead to cracks, blisters or sores that can lead to infection. Proper trimming and thinning of the nails are essential. If they are too thick, they can cause an ulcer under the nail or a cut in the skin if there is an ingrown toenail.
The podiatrist may also take a nail sample to validate the presence of a fungal infection. A prescription for topical medication may be given by your podiatrist. If oral medication is required, a referral will be made to the attending family doctor.
DIABETIC WOUND CARE (ULCERATION):
- Identification of cause
- Cleaning and debridement of non-healthy tissue
- Application and prescription of appropriate dressings
- Prescription of an appropriate discharge modality
- Careful follow-up appropriate to the situation
- Referral to another health care professional, if necessary.
VASCULAR TEST:
It is very important to assess the blood flow in the feet, since 60% of people with peripheral vascular disease show no symptoms. The podiatrist can perform various tests to check the integrity of the arteries. A thorough examination involves palpating the arteries in the foot, listening to the circulation by doppler and measuring the tibio-brachial index. A thorough examination can lead to prompt intervention and prevent ulceration, gangrene and amputation.
FOOT ORTHOTICS:
Foot orthotics are a tool of choice in the prevention of wounds through proper plantar pressure distribution. The choice of orthotic features and materials is specific to each patient’s condition. Only a podiatrist or a physician can prescribe a foot orthoses and perform the appropriate follow-up.
NEUROLOGICAL TESTING:
Assessment of foot sensation in diabetic patients is important because it assesses their potential risk for complications. Two tests are frequently used to assess the level of foot sensation. The first test consists of the perception of a vibration through a tuning fork. The second test is performed with a monofilament. It allows to detect the ability to perceive the fine touch at various pressure points.
BIOMECHANICAL EVALUATION:
A comprehensive biomechanical evaluation allows us to measure lower extremity function, gait and posture. This will allow us to detect asymmetries, foot deformities, loss of balance and poor plantar pressure distribution. A thorough examination will help prevent the formation of plantar ulcers and other risks of diabetes-related complications.
REDISTRIBUTION OF WEIGHT:
When a wound is present, off-loading is essential to its healing. The podiatrist is able to determine the best tool for the type of wound and your condition.
Some cases require an off-loading shoe or boot, a cast or a plaster boot to achieve optimal wound healing. A foot orthotic and regular debridement of corns and calluses is a good way to prevent wound recurrence.
Learn more about diabetic foot treatments:
– Understanding the diabetic foot
– Symptoms of the diabetic foot
– Preventing Diabetic Foot Problems
– What Causes Diabetic Foot
– Common Diabetic Foot Problems
– When to make an appointment with a podiatrist for diabetic foot treatment