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DIABETES AND YOUR FEET – THE IMPORTANCE OF PODIATRY Written by Kathryn Miller (Podiatrist)

Updated: Apr 15


A physiotherapist checking a patient's foot for pain

Diabetes is a complex medical that can affect the whole body making it important to have the right medical supports in place. It can cause very serious complications where symptoms of complications can be very mild or undetectable initially so are commonly diagnosed later once they have started to cause problems.

Working with your team of health practitioners to monitor your diabetes and screen for complications, endeavoring to maintain stable blood glucose levels (BGLs) within the recommended range and having a healthy lifestyle help reduce any effects of diabetes. Podiatrists are university qualified health practitioners with training in diabetes assessment and care of the lower limb (legs and feet).

Your feet are one part of the body that can be affected by diabetes – particularly when it’s poorly controlled or you have had it for a long time. A podiatrist not only can help you with safe foot care for nail and skin conditions, they also perform regular foot assessments for diabetes. These annual (or more often if higher risk) foot assessments with a podiatrist check the status of your overall foot health, your blood supply to your feet and your sensation (nerves) – both which can be affected by diabetes and can lead to complications including ulcers (wounds) and sometimes can lead to amputation.


HOW DOES DIABETES AFFECT THE FEET?

There are two main complications of diabetes that affect the feet:

  • Reduced blood flow/circulation caused by narrowing and hardening of the blood vessels in the legs and feet. This can cause delayed or poor healing of any cuts/wounds and can cause pain.

  • Loss of protective sensation/feeling (peripheral neuropathy caused by damage to the nerves in the feet). Unfortunately when you can’t feel your feet, you don’t know when something is going wrong – cuts, bites, wounds, infections, burns.

According to Diabetes Australia, there are more than 4,400 amputations every year in Australia as a result of diabetes.

Your podiatry diabetes assessment at In Stride can:

· Check you blood flow including use of a doppler ultrasound

· Check your protective sensation

· Assess and treat your nails including professional cutting of your nails – including thickened, fungal and ingrown nails.

· Assess and treat your skin conditions (including corns, callouses, warts, wounds, infections).

· Analysis of your foot posture and pressure issues including arch supports/orthotics if required

· Diagnosis and management of muscle and joint conditions including injury, arch/heel pain, arthritis and bunions.

· Wound dressings

· Footwear and foot care advice

· Education about managing diabetes and foot conditions to prevent problems

· Referrals for further assessment/treatment e.g. vascular specialists, dietitian


There are quite a few things you can do to help your feet and reduce the risks associated with diabetes. These include:

· Wear correct fitting shoes (get a width and length fitting).

· Wearing socks made of natural fibers (cotton, wool) which breath well – look at “diabetes friendly” options which often are loose topped or don’t have seams that can rub.

· See your podiatrist for safe removal of hard skin and for nail cutting.

· Check your feet daily – its good to use a small mirror like a shaving mirror to look at the hard to see parts of your feet.

· Maintain good foot hygiene – clean feet, dry well between your toes and use an emollient on your heels/soles to avoid dry and cracking skin.

· Avoid being barefoot – use shoes to protect and support your feet.

· Maintain good blood sugar control

· Don’t smoke

· Have a healthy lifestyle – good diet and regular exercise play an important role

· Have regular check ups with your GP and other health professionals as appropriate.


The podiatrists at In Stride (Kath and Emily) welcome the use of Medicare Enhanced Primary Care/Chronic Disease plans which entitle those with diabetes to 5 rebates with allied health practitioners. This includes our podiatrists, dietitian and physios.

At In Stride, we can work together with the other services we offer and liase with your GP and any diabetes specialists to coordinate your care.

We look forward to working with you to keep you and your feet healthy and comfortable – afterall, they are your main mode of transport!


References:




Image of Kathryn Miller - direct & podiatrist of In Stride Health Clinic


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