The Diabetic Foot Stay one step ahead in the Management of your Diabetes
Posted: Sunday, August 02, 2009
by GARY WEBB
WEBB'S PODIATRY
In diabetes one of the main causes of ulceration in the diabetic foot is poor tissue oxygenation, which is caused by blocking of the large or small vessels. This can lead to very slow wound healing and make infection more likely, which can in severe cases lead to gangrene in the foot. Obviously early intervention in these cases is a priority as loss of limb can be a main cause of early morbidity. Where the circulation is severely compromised it is very difficult for the infection to clear. Foot ulcers affect 1 in 10 of Diabetes sufferers.
-Extrinsic pressure from tight shoes.
-Prolonged heel pressure.
-Intrinsic pressures from chemical mediators of infection within the body.
-Walking in bear feet and treading on a pin or sharp object which may not be felt due to loss of sensation.
-Foot type- high arch or flat feet etc.
-Calluses
-Blisters
-Athletes foot
Important steps to avoid foot ulcers
-It is important that if you have poor circulation that your feet are checked on a regular basis by either a Podiatrist or other medically trained professional. The lower limb foot pulses will be checked, with the skin and nails for any signs of poor foot circulation.
-Proper accommodative footwear must be worn to avoid any shearing forces, which causes blistering of the skin.
-Check your feet daily for any changes in skin colour, blisters and calluses etc. All these could lead to ulceration and possibly gangrene, with loss of limb.
-Orthoses to correct any problems with your gait or excessive foot pressures.
-Padding's or strapping's for excessive foot pressure or shearing forces which can lead to ulceration.
-Heel pads.
-Use Foot cream daily to avoid dry and cracked skin, which can be a common source of foot infection.
-Dry your feet thoroughly.
-Control your Diabetes with regular exercise, healthy eating and an aggressive treatment regime to control the blood sugars.
-Avoid smoking.
-Check your shoes for any signs of wear and inside for foreign objects such as sharp edges.
Loss of sensation Diabetic Neuropathy
Loss of sensation can develop in the feet over time. This condition is known as Diabetic neuropathy which manifests itself as peripheral neuropathy and usually affects the sensory nerves in the legs. Again it is important to have a regular test for this condition by a podiatrist or other medically trained professional.
Why it is vital to check for loss of sensation
If the nervous system becomes damaged it is possible for the feet to become numb. This can become painful in the early stages with a condition sometimes developing known as painful neuropathy. It is possible that your skin may be damaged through trauma or infection, even callus formation or standing on a pin and you could be totally unaware of the seriousness of the situation. As a foot ulcer could easily develop and you may be unaware due to the loss of sensation. Neuropathy can cause the heels to crack and the skin to dry out and pressure from daily walking may go unnoticed. Your Podiatrist will grade your feet from low risk to high risk, if you are more at risk of ulceration.
To recap it is important that you have a regular foot health check 6 monthly to yearly. Check your feet and inside your shoes daily to avoid any potential problems.
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