Diabetes can have a devastating impact on your feet because of the way it affects your sensation (your ability to feel) and your circulation (the blood flow to your feet). The result is a serious risk for developing wounds, infections and ulcerations on the feet – which is why it’s so important to pay special attention to your feet and why it is referred to as the ‘high-risk’ foot.
The symptoms of diabetes on your feet may start small, but will progressively worsen over time. This means that foot care, advice and management strategies need to be specific to the symptoms you’re currently experiencing and that these will change over time. This is why it’s very important to have annual diabetic foot health checks to keep you informed about how to best manage your foot health.
When we talk about the way that diabetes affects the feet, we talk about the way it affects your sensation and your circulation at the feet.
Diabetes causes damage to the nerves in your feet and legs. As the nerves are responsible for our ability to feel by relaying messages from the nerve endings on our skin to the brain, nerve damage means that our ability to feel worsens, can become mixed up, and may eventually be lost altogether. This is called peripheral neuropathy. These altered sensations often affect the extremities, with changes in the feet typically occurring before the hands. Symptoms include:
Ultimately, you may completely lose sensation in the feet. Unlike the blanket-like feeling of numbness, any feeling in the affected areas of the foot will simply be absent and you may not even realise that the sensation isn’t there. This is the most dangerous symptom as it renders you vulnerable to incurring an injury such as a cut or burn and not being able to feel it, hence not taking action to treat and manage it. This injury may easily be something small like a pin, nail, or splinter. Any wound that results will be susceptible to infection, and when continued to be left untreated, the area may ulcerate.
Diabetes also causes damage to the blood vessels, impairing the blood flow to the feet. Poorer blood supply to the feet means less oxygen and nutrients are delivered to a wound within a certain length of time, meaning that the body will take longer to heal any cuts and breaks in the skin. If blood flow to the feet is impaired, you may experience:
When paired with an increased likelihood for undetected cuts and wounds from a diminished ability to feel, this is a very dangerous combination. It poses a significant risk of infection, ulceration, and at its worst, amputation. Diabetes is currently the leading cause of lower limb amputation, other than traumatic injuries.
While type 1 diabetes is present at birth, type 2 diabetes can develop at any point throughout your life. It occurs when your cells become resistant to a hormone called insulin, which functions to direct sugar out of the bloodstream and into the cells. This means that sugar can build up in the bloodstream and cause damage to the vessels.
While diabetes requires a whole-body management plan, you can help manage the effects on your feet by:
Our podiatrists are qualified to help you manage the symptoms of diabetes on your feet, and help you stay in control of your foot health. If you have diabetes, it is recommended that you have an annual assessment of your sensation and circulation, so you know the status of your foot health and your risks. We give you advice and management strategies to help reduce the risk of complications and achieve the optimum outcomes for your feet.
During your assessment, we check every surface of your foot, including between the toes, to look for warning signs or changes from your last appointment. We’ll also help manage any wounds that develop, can recommend diabetic-friendly footwear, and use devices like orthotics to help you feel more comfortable on your feet and reduce your risk of injury.
Diabetic foot disease is the leading cause of lower limb amputation aside from accidents/trauma. The key to amputation prevention is early recognition and foot screening, at least annually, of at-risk individuals. Those individuals considered to be at high risk are those who exhibit one or more of these six characteristics: