How Does Diabetes Affect The Feet?
Updated: Dec 4, 2022
Diabetes is a chronic health condition which, according to the Australian Institute of Health and Welfare, currently affects approximately 5% of the Australian population. Unfortunately, these numbers are continuing to rise. Diabetes results from the body’s inability to handle sugars correctly, leading to increased blood glucose levels. The effects of this on the feet can be quite severe and even life threatening.
What is Diabetes?
There are two main types of diabetes which can lead to foot issues:
Type 1 Diabetes: Type 1 diabetes is typically diagnosed in childhood or early adolescence. It is an autoimmune condition which leaves the body unable to produce insulin, a hormone necessary for blood sugar regulation. Individuals with Type 1 Diabetes require regular insulin replacement therapies to survive.
Type 2 Diabetes: Type 2 diabetes is more commonly diagnosed later in life though cases of younger individuals developing this condition have been reported. Type 2 diabetes results from a combination of genetic and lifestyle factors which lead to the body no longer being sensitive to insulin. This results in excessively elevated blood sugar levels which may require medications to control. Type 2 diabetes can be effectively controlled through modification of diet and lifestyle.
What Does Diabetes Do To The Feet?
Given their location at the extremity of the body, the effects of uncontrolled diabetes often present in the feet before anywhere else. There are three main ways in which elevated blood sugar levels affect the feet.
Hardening of smooth muscle surrounding arteries: Diabetes can lead to a reduction in the elasticity of your arteries. When the arteries are less elastic, they carry less blood to the extremities and as such the amount of blood, oxygen and nutrients getting to the feet is reduced. This leads to complications such as poor perfusion, cold feet and very slow healing of wounds on the feet.
Peripheral Neuropathy: This is a medical term to describe the deadening of the nerves in the extremities. This typically begins as a change in sensation - pins and needles or a feeling of “wearing a sock” even when barefoot. This can progress to complete loss of sensation in the feet. Aside from being uncomfortable, this has very serious consequences in knowing when you have hurt yourself. I have had individuals present to the clinic with various objects lodged in their feet and they are completely unaware. I have also had patients who have only known they had hurt their foot by the trail of blood left on the floor.
Stiffening of connective tissues: Increased sugar levels in the blood can bind to connective tissues, stiffening them and making them more brittle. This increases the likelihood of injuries such as tendon tears and ligament ruptures.
One of the worst outcomes can occur when a patient develops neuropathy and they have reduced circulation. They may injure themselves without being aware of it and given the slow healing rate, there is a very high likelihood of infection. When there is reduced circulation, there is a reduced immune response and the patient’s infection does not resolve. In the worst instances, this can result in hospitalisation, amputation and even death.
What Can Be Done At Home To Care For Diabetic Feet?
Being actively involved in your diabetes care is critical to long term health. Here are ways to prevent foot complications at home.
Ensuring blood sugars remain stable: Avoiding sugary foods that spike blood sugars, exercising regularly and taking all prescribed medications can keep blood sugars stable. This will prevent the complications discussed above.
Regularly checking feet: Examine the bottom of feet daily to ensure there are no cuts or pressure areas. If you are flexible enough, you can bring your foot up to check it, otherwise placing a mirror down low to the floor or getting a family member to look over your feet will allow you to detect any issues early before they become serious.
Avoid spending time barefoot: Wearing enclosed shoes provides protection against possible trauma. Before putting shoes on, make sure to check them to ensure they are clean with no stones or other foreign bodies in the shoes.
Discuss diabetes management and care with GP’s and other allied health professionals: Working closely with health professionals gives the best chance of living a life without diabetes related issues.
How Can A Podiatrist Help?
We would recommend an appointment as soon as possible if you are experiencing:
Wounds on the feet.
Areas of thickened and hard skin.
Numbness, cramping, or sharp shooting pains in the feet and legs.
What kind of assessments are completed at a diabetic foot check?
A comprehensive history is taken. This includes questions about your medical history, medications, allergies, etc.
Footwear checks. Remember to bring the shoes you wear the most!
Assessment of the arteries and nerves of the feet.
The condition of your skin and nails.
An assessment of your joints and muscles. Here we look at any joint restrictions, muscle weakness, or the source of any foot pain.
After these assessments are complete, your Podiatrist can:
Discuss your risk of developing foot complications (in accordance with the diabetic foot care guidelines) and how we as Podiatrists can assist you with foot care and monitoring.
Things you can do to care for your feet at home.
Provide footwear recommendations based on your activities.
Provide reports to be sent back to your medical team (typically your general practitioner).
Facilitate any imaging or further referrals (if necessary).
Diabetes is a chronic health condition and individuals suffering from diabetes may be entitled to Chronic Disease Management (CDM) and Enhanced Primary Care (EPC) Plans through their GP. At My Family Podiatry, individuals with a valid EPC are bulk billed for their appointments.
If you or someone in your family is a diabetic, it is important you receive regular podiatry assessments. For a detailed and thorough assessment, contact My Family Podiatry on 07 3088 6116 or click through the link below to book an appointment today.