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Keeping your feet healthy

Not all people with diabetes will get foot problems but you are more at risk of developing foot problems than a person who does not have diabetes. About 1 in 10 people with diabetes can develop foot problems at some stage and if not dealt with quickly can sometimes lead to very serious problems. If you have poor blood glucose control, if you smoke, if you have had foot problems in the past, if you have kidney problems of if you have swollen feet and ankles then you are at increased risk of foot problems. Everyone with diabetes must be very careful and look after their feet.

 
 
What kind of foot problems should I look out for ?

 

Small Wound| Hot water bottle burn | Deformity | Blisters | Ulcers

 

What are the causes of diabetic foot problems ?

 

  • Nerve Damage (known as Peripheral Neuropathy)

Nerve damage causes reduced sensation in your feet. High blood sugar levels can damage the nerves in your feet and if the nerves are not working properly, messages to your brain telling you that your foot has an injury, may be impaired. For example you maybe unable to detect if your foot has a burn or if you have stood on something sharp. Even a blister from a badly fitted shoe may develop into a large sore. Sometimes, if the nerves are damaged in your feet, you will develop odd sensations and pain in your feet. This commonly occurs at night. If this becomes troublesome speak to your podiatrist or doctor, as you can be prescribed suitable pain relieving drugs.

 

  • Poor circulation (known as Peripheral Vascular Disease)

If you have diabetes the flow of blood to your feet may be affected. High blood sugar levels can cause the development of atheroma or ‘fatty plaques’ on the walls of the arteries in your legs reducing the artery diameter and thereby reducing the blood flow to your feet. If your blood flow is reduced your ability to fight foot infections and heal foot wounds is reduced. A small cut or minor infection can be difficult to heal and may progress into a more complicated wound.

 

You should have a yearly foot examination to check for the presence of Neuropathy or Peripheral Vascular Disease.
What can I do to keep my feet healthy ?

 

The good news is that the majority of foot problems can be prevented. Looking after your diabetes well reduces your risk of getting peripheral neuropathy and peripheral vascular disease. Making sure that your blood sugar, blood pressure and cholesterol levels are kept as close as possible to the target values advised by your Doctor or Diabetes Specialist Nurse greatly helps prevent the development of foot complications associated with diabetes.

 

Here is what you can do to look after your feet and keep them healthy: -

 

  • Check your feet daily. If you are unable to reach your feet or see them, ask someone to check them for you. It is important to get into habit of daily foot checks especially if you have nerve damage or bad circulation.

 

  • Check for injuries. Remember you may not be able to feel a foot injury. There may be small cuts, foreign objects such as thorns, blisters, in-growing toenails, callus, corns, areas of redness or new discoloration or swelling.

 

  • Wash your feet daily in warm, soapy water(but do not soak them). Check the water to ensure it is not too hot. Use your elbow or a thermometer to check the temperature before placing your feet in the water. Remember your feet may not detect that the water is too hot. Dry your feet well especially between the toes, checking all areas as you do so.

 

  • Keep your skin texture good by applying creams or emollients after your footbath . Pay particular attention to the heel area and avoid applying cream between the toes.

 

  • Do not go barefoot.

Always wear footwear, checking the insides for any rough areas or foreign objects, which may cause damage. Remember to check your socks or stockings.

 

  • Ensure you cut your toenails straight across .

If you are able to reach your feet, see what you are doing and have no problems with your feet, there is no reason why you cannot cut your nails. But be careful. A friend may be able to help. Do not ‘poke’ down the sides of your nails. File your nails after you have cut them to smooth away any sharp edges. If you are having difficulty with your nails or if you have any concerns contact your podiatrist.

  • Do not use corn cures or perform ‘Bathroom Surgery’!
  • Ensure you are wearing appropriate footwear . This is really important. The majority of foot problems are caused by ill-fitting footwear. It is extremely important to wear appropriate footwear. Footwear should be wide enough at the toe box to accommodate your toes. It should also fasten securely with a sole that provides shock absorption when walking. Avoid wearing sling backs, mules or high heels. Always feel inside your shoe before putting it on to check for any foreign objects. I f you find it difficult to find suitably fitting footwear, speak to your Podiatrist. They will advise you on footwear and if needs be, arrange for you to visit an orthotist to see if you need specially made footwear.
  • Get help quick if you detect a problem or injure your feet. If you do have a small cut or broken skin on your foot, it is important to make sure it does not become infected. Clean the wound with salt and water, apply an antiseptic and cover with a sterile dressing. Then contact your GP, Practice Nurse or your Podiatrist without delay. If in doubt do not take any chances – get help and advice.

 

  • Make sure you get an annual foot check at your diabetes clinic. Folks with diabetes must have their feet checked annually to see if they are at risk of foot problems. At each examination you should receive foot health education to help you reduce the chances of getting foot problems. Your foot examination should include checks to see if there is any nerve damage. A machine called a neurotheisiometer may be used to see whether you can detect vibration. A Monofilament can be used to check your sensation. Your pulses in your feet will be checked. If there are any concerns about the circulation in your feet who may need tested using a Doppler machine.

 
How can I contact a podiatrist ?

 

  • It is so important not to delay in contacting a podiatrist if you are worried about a foot problem. It is easier to manage a foot problem in the earlier stages and prevent deterioration into a much more serious foot problem. If you have never had contact with your Podiatrist, contact your GP for a referral or your local health centre.

    For the Ulster Community and Hospitals Trust Podiatry Service Contact:

The Podiatry Department

Ards Community Hospital


Church Street

Newtownards

BT23 4AS

Tel: 02891 510241

The Podiatry Department

Bangor Community Hospital

Castle Street

Bangor

BT20 4TA

Tel: 02891 475138

The Podiatry Department

Ulster Hospital


Dundonald

Belfast

BT16 1RH

Tel: 02890 484511 Ext.2801