Diabetic Foot Care
Diabetes can affect the feet in many ways. There are a number of risk factors associated with diabetes that can complicate one’s foot health, including poor circulation, loss of nerve sensation, skin and nail changes, and the mechanical structures of the feet. Diabetes can lead to foot ulceration, infection, and in severe cases amputation. A Chiropodist can provide a full assessment of a diabetic foot (or feet) and determine the risk level of complications. A Chiropodist can also provide general nail care and callus debridement on a monthly basis, continual assessment of the feet to reduce the risk of any complications, and treat foot ulcers to ensure proper wound closure and to reduce the risk of major infections.
Diabetic Foot Conditions
Feet presentation may vary in a diabetic foot. There are various risk factors to consider including vascular circulation (blood flow in arteries and veins), neurological conditions (nerve function and sensation), dermatological conditions (nail + skin presentation), and mechanical function of the feet (toe deformities, joint range of motion). Feet presentation can also depend on how long one has been diabetic for, and how well they are able to control their blood sugar levels. The following are common presentations seen in a diabetic feet:
Dried crack skin
Neuropathy occurs when one loses the ability to feel the sensation in the bottom of their feet. With longstanding diabetes and elevated blood sugar levels, nerve cells can get damaged causing neuropathy. Generally patients may begin to complain of numbness or tingling in the bottom of their feet. As it progresses we begin to see changes in presentation
of the feet, which may lead to higher risk of foot complications. When visiting a Chiropodist, a sensory test is performed to ensure nerve sensations are intact .
An ulcer is an open sore that can occur anywhere along the legs, ankle, and feet. Ulcers can arise as a result of neuropathy. When one loses the sensation at the bottom of the feet, they lose the ability to sense any pain, aggravation, pressure, and trauma to the foot.
Ulcers require special care and treatment. They can vary in size, shape, and presentation. Due to diabetes, ulcers can have delay healing. It is therefore important to begin treatment immediately to prevent further complications.
Gangrene is a more severe state of diabetic feet. Gangrene can arise either due to lack of blood flow to the feet, or due to severe bacterial infection. The affected area on the feet will turn black in color, and may look dry (mummified appearance) or may look wet (have pus discharge, with foul odour). If not treated promptly, it can lead to toe or even foot amputation. It is important to seek immediate treatment when the feet are in this state.
The goal of Chiropody treatment is to prevent foot amputations. Individuals with diabetes should book regular foot care treatments, including nail clipping and callus removal to prevent foot ulcerations. In the event that foot ulcers arise, a Chiropodist will be able to provide treatment and prescribe antibiotics if necessary.
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