They move you from A to B. They let you know when the sand at the beach is blistering hot. They also take the painful hit when you connect with the edge of the coffee table. Feet rarely complain, they just get on with doing their job of supporting you. But outside of putting on your shoes and socks each day, how well do you know your feet?
For people living with diabetes, feet are often over-looked as the management of other aspects of diabetes takes higher priority. However, foot problems are extremely common and often debilitating for people with diabetes. So slapping on a band-aid, ignoring foot changes, or saying 'it'll be right in a few weeks' could be putting your valuable feet at risk of diabetes-related foot problems.
The good news is that there are several preventative steps you can take yourself to help reduce the chances of developing diabetic foot disease. By following a daily foot care routine at home and having regular foot monitoring with your health professional, most foot problems are avoidable.
So, are you putting your healthiest foot forward?
A common symptom of diabetes is damage to the nerves in your feet. The damaged nerve function is called neuropathy, and about half of all people with diabetes have some form of nerve damage.
Neuropathy results in either pain, tingling, weakness or reduced sensation in the feet and lower limbs. A loss of sensitivity in the feet often leads to an abnormal walking pattern causing increased pressure in certain areas of the foot. The development of callus can be an indication of abnormal pressure being applied and continuing to walk unnaturally on an ‘insensitive foot’ increases the likelihood of ulcers forming, and reduces the ability of the body to heal an existing ulcer.
Because of the loss of sensation in the foot, a person with diabetes is less likely to realise when they’ve injured their foot, as they may not feel the pain. This means they are less likely to notice and treat an injury, allowing it to progress to a more serious, advanced stage.
The most common of these problems is the diabetes-related foot ulcer, which is a wound occurring on the foot, commonly caused by a lack of sensation and/or poor blood supply in a person living with diabetes.
Slapping on a band-aid, ignoring foot changes, or saying ‘It’ll be right in a few weeks’ is putting your valuable feet at risk. Don’t wait for the problem to get worse, as time is an important factor in preventing serious complications. If you are experiencing any of the following foot problems call your health professional as soon as possible for examination.
INJURY
You have a current, untreated ulcer or your feet show any sign of injury that becomes red or isn’t healing.
PAIN
You notice pain, swelling, throbbing, temperature changes in the feet (especially heat) or changes to skin colouration.
SENSITIVITY
Your feet have noticeable changes in sensitivity (or loss of sensation) or appearance.
Foot care is vital for people with diabetes and fortunately, many foot problems are preventable. With daily foot checks and recommended lifestyle changes, many people with diabetes are able to prevent foot ulcers and their more serious complications, such as amputation. By introducing simple steps into your daily routine, the risk of foot problems can reduce significantly. So...how well do you know your feet?
Download our updated diabetes feet health passport that walks you through the daily steps to help take care of your valuable feet.
Did you know that wearing the right footwear and introducing a footwear routine is one of the easiest ways to help take care of your valuable feet.
Protect your feet
Wear well-fitting footwear, both indoors and outdoors. This is important as you can easily injure your feet, by stepping on something hard or sharp, without realising (due to loss of sensation).
Wear Socks
People with diabetes should always wear socks within their footwear to reduce rubbing. Socks should be made of mostly natural materials, should be seamless and shouldn't have elasticated cuffs.
Check your shoes
Never store things in your shoes, as injuries can result. Check inside shoes before putting them on, for small pebbles, foreign objects or rough stitching. Also check your feet when you take your shoes off.
Avoid ill-fitting shoes
When shoes don't fit well and are too tight, chafing and blisters may result. It's important for people with diabetes to wear footwear that fits and protects. Speak to a podiatrist to see if you require specialised insoles or custom-fitted footwear.
Even minor injuries caused by a small cut, bruise or a blister can develop into a diabetes-related foot ulcer.
Diabetes-related foot ulcers can occur in people with both Type 1 and Type 2 diabetes. The term 'foot ulcer' refers to a break in the skin on the feet. For people with diabetes, high or fluctuating blood sugar levels, reduce blood flow to the extremities and nerve damage can inhibit the ability of the skin to repair itself. Because of this impaired rate of healing, even a minor injury can start a foot ulcer.
The occurrence of a foot ulcer is an unpleasant experience, causing pain and discomfort, the need for regular attention (eg. wound dressing), and often taking a lengthy time to heal. If you notice an injury or ulcer on your foot or lower leg, we recommend seeking advice from a health care professional (such as a GP or podiatrist) as soon as possible. Prompt attention will allow treatment to start as early as possible, giving you the best chance of faster and more successful healing.
Unfortunately, foot ulcers that progress to more advanced stages may become infected and can ultimately result in amputation. The personal impact of amputation is of course significant, resulting in reduced mobility, and often a sense of dependence and isolation. Don't wait for the problem to get worse as time is an important factor for foot changes. If you are experiencing any of the following foot problems make an appointment with your health professional as soon as possible.
Do you know your foot risk status?
Ask your health professional to check your feet at each diabetes check-up and mention any changes you have noticed in your feet or legs.
Preventing and managing diabetes-related foot disease is a joint effort between your health professional and you. Up to 85% of non-traumatic lower limb amputations in Australian people living with diabetes can be prevented with management and best practice clinical treatment. When a new foot problem develops, it’s important to seek urgent medical attention for your health professional to review, as early treatment is key to preventing serious complications.
Over the last 30 years, expert multidisciplinary teams have been shown to be more effective in managing diabetes-related foot ulcers compared to solo expert health practitioners. So what should you expect when checking in with your own diabetes-related foot team?
Medication
Your current medication should be checked for both your foot health and general health.
Assessment
Your ulcer should be properly assessed to see if it's improving or needs different treatment.
Debridement
Any unhealthy skin on and around your ulcer should be removed if possible.
Antibiotics
If your ulcer has become infected, new antibiotics should be prescribed.
Dressing
The correct dressing should be applied that properly absorbs the ulcer fluid.
Offloading
The right offloading device should be prescribed to remove the most pressure on the ulcer.
Referral
If the ulcer needs more specialised treatment, your team should refer you to the specialist you need.
Education
Advise you on how you can help your ulcer at home and what to look out for between visits.