Diabetics must constantly monitor their feet or otherwise they could face severe consequences, including amputation. Approximately 80% of life altering amputations could have been prevented had they been regularly monitored.

Foot problems for diabetes sufferers are usually the result of three primary factors: neuropathy, poor circulation, and decreased resistance to infection. Also, foot deformities and trauma play major roles in causing ulcerations and infections in the presence of neuropathy or poor circulation.

Peripheral Neuropathy
Patients, who suffer from neuropathy, find it increasingly difficult to distinguish between hot and cold and dull and sharp, as well as the ability to feel pain and pressure. This could lead to potentially dangerous and undetected injuries for a diabetic. The risks of developing ulcers and infections are significantly increased.

Poor Circulation
Poor circulation inhibits the body's ability to allow adequate blood flow to extremities. Blood carries the necessary oxygen and nutrients necessary to aid in the body's healing processes as well as keeping those body parts active and healthy. Poor circulation to the feet and legs slow down the healing process when injured. When your wound is not healing, it's at risk of infection. As a diabetic your infections spread quickly and greatly increase the risks to contract gangrene.

Foot deformities
When your foot becomes numb, they are at risk of becoming deformed. The bone condition Charcot foot is one of the most serious foot problems as it warps the shape of your foot. With Charcot foot your bones fracture and disintegrate and eventually this could lead to severe deformities in your foot. Large bony overgrowths develop as the body replaces lost bone with the new bone and may protrude from the top of the foot. Calluses and ulcers may form when bony protrusions rub inside the shoes. Infected pressure ulcers and osteomyelitis (inflammation of the bone caused by infection) may develop. As this can be very disabling, early diagnosis and treatment is vitally important.

Most of these problems are preventable through proper care and regular visits to your podiatrist. Proactive screening, regular assessment and education are effective measures to detect and help to prevent early foot problems, thus reducing amputation rates.  At the Waldegrave Clinic, our podiatrists are specialist at helping Diabetes patients and offer:

Screening
Blood supply will be checked by looking at the colour of your skin, checking the pulses in the feet and by asking questions about certain kinds of pains in your feet and legs. Sensation will most commonly be checked with a monofilament and tuning fork. We also do a simple test to check the level of feeling in the foot.

Management strategies
•    Once the level of risk for foot injury or ulceration has been determined appropriate management schemes including footwear recommendations or education referral to specialist care will be advised.
•    High quality clinical care is provided in conjunction with routine care for those patients deemed at high risk.

Education
•    Provide intensive one to one education for the patient in all aspects of foot health.
•    Update all other health professionals (Your GP, District Nurse) and carers on foot health advice.

If you are Diabetic and are worried about your feet, please book a 'Diabetic Foot Check' with one of our podiatrists, call our reception on 0208 943 2424.

Sagara Palliyage, Podiatrist at the Waldegrave Clinic