With diabetes on the rise in Australia we are seeing a steady increase in patients presenting at our podiatry clinics with foot and lower limb conditions. Worryingly, many diabetes sufferers are unaware that there are several diabetic foot conditions that can lead to amputations or be fatal to the sufferer if left untreated. As a result, we have written a blog that explains the relationship between diabetes and foot health.
What is Diabetes?
Diabetes is a chronic disease characterised by high levels of glucose in the blood. Blood sugar levels are controlled by insulin, a hormone produced by the pancreas. Diabetes occurs when the pancreas is unable to produce enough insulin, or the body becomes resistant to insulin, or both. There are three main forms of the disease:
- Type 1
Is an autoimmune disease where the body’s immune system attacks the insulin producing cells of the pancreas. People with type 1 diabetes cannot produce insulin and require lifelong insulin injections for survival. The disease can occur at any age, although it mostly occurs in children and young adults.
- Type 2
Is associated with hereditary factors and lifestyle risk factors including poor diet, insufficient physical activity and overweight or obesity. People with type 2 diabetes may be able to manage their condition through lifestyle changes; however, diabetes medications or insulin injections may also be required to control blood sugar levels
Occurs during pregnancy. The condition usually disappears once the baby is born, however, a history of gestational diabetes increases a woman’s risk of developing type 2 diabetes later in life.
Why are diabetics more prone to foot complications?
Reduced blood flow to the feet (poor circulation)
When the sugar levels in the blood are higher than they should be, the excess sugar can cause permanent damage to the blood vessels.
When combined with other health problems such as high cholesterol or high blood pressure, the artery walls can become thick, hard and blocked, thus reducing the amount of healthy blood getting to the feet. This is known as Peripheral Vascular Disease (PVD). This causes delayed healing and an increased risk of infection.
Nerve damage (Peripheral neuropathy)
Excess sugar can also enter the nerve fibres and once this happens, the sugar causes irreversible damage to the nerves. This generally results in a loss of feeling or numbness or burning in the feet. When a person loses feeling in their feet, they are at risk of developing wounds on their feet, that they may not necessarily be able to feel.
How can a Podiatrist assist someone with Diabetes?
Regular foot checks and diabetes foot assessment
We recommend people with diabetes to have an annual or bi-annual appointment to have their circulation and nerves tested in their feet. This will help us determine to amount of blood flow getting to the feet and the degree of feeling in the feet. We can also recommend referrals to vascular specialists for further treatment or assessment when deemed necessary.
Regular routine nail and skin care
A podiatrist is specifically trained to provide treatment for toenails and hard skin (callouses) on the feet. Self-treatment of these conditions at home can put the person at a higher risk of infection if not treated correctly. A podiatrist always uses sterile instruments to professionally treat these conditions in a safe manner.
Footwear advice and checks
Incorrect or poorly fitting footwear can place a diabetic at higher risk of developing foot ulcers. A Podiatrist can ensure your shoes are the right width, length and depth for your feet. We can also provide recommendations for diabetes friendly footwear and socks which have no seams or stitching which could potentially irritate the feet and cause a wound.
Facts about Diabetes
- Recent statistics estimates there are 1.2 million people in Australia living with diabetes. Of that group, 85% of them have type 2 diabetes. The rate of people being diagnosed with diabetes is on the increase.
- 280 Australians develop diabetes every day. That’s one person every 5 minutes
- Diabetes is the leading cause of preventable blindness in Australia
- There are more than 4400 amputations every year in Australia as a result of diabetes
- in 2005, more than 1000 people with diabetes died as a direct result of foot ulcers and lower limb wounds.
- Every year there are 10,000 hospital admissions for diabetes related foot ulcers.
- People with diabetes are at risk of bladder and kidney infections, kidney failure and dialysis.
If you have diabetes, you may be eligible to receive podiatry consultations with a Medicare rebate through the Enhanced Primary Care program. Speak with your GP to discuss your suitability. Identifying issues and preventing them is paramount to maintaining good foot health and avoiding lengthy hospital visits. Don’t become another statistic!