Foot Health And Diabetes
What is neuropathy?
Diabetic neuropathy happens in people with type 1 and type 2 diabetes and is the most common cause of loss of feeling in feet and legs.
Diabetes-related foot complications develop as a result of high blood sugar (glucose) levels over time.
Damage to the nerves results from erosion of the protective sheath surrounding the nerves. This can result from raised blood glucose levels disrupting the structure and function of the nerve, or reduced flow in small blood vessels supplying nerves in the feet.
Neuropathy can affect nerves throughout the body but due to the long length of the nerves to the foot, damage happens there first.
Diagnosis and treatment
You should have your feet assessed annually for neuropathy if you have type 1 or type 2 diabetes.
Tests include the use of a monofilament (a graded nylon filament applied to the foot), or using a tuning fork, which tests the perception of vibration. These tests help to diagnose neuropathy and reduce the risk of foot ulcers developing.
Reduced blood supply to the foot should always be taken seriously. Exercising and stopping smoking are essential to combat any further problems with your feet.
Medication for raised cholesterol and high blood pressure may also be appropriate. Other treatments are available, so ask your healthcare team about all of your options.
Top tips for healthy feet
- Check your feet daily. If you have poor sight, ask a family member or carer to help. Look for colour change, swelling, damage to skin, heat, redness, discharge and pain/discomfort.
- Hard skin (callus). Never try to treat corns or hard skin yourself. A trained podiatrist will remove the callus or corn thereby reducing pressure on the area. If not treated, the pressure may lead to ulceration. Never apply corn plasters or acid preparations. They can burn the skin and cause a wound. Neuropathy or ischaemia makes you especially susceptible.
- Nail care. If you can easily cut your toenails yourself, do not let diabetes stop you. Trim them straight across and file rough edges. If you suspect a deformity, infection or ingrown nails, consult a podiatrist.
- Footwear. Always wear footwear for protection; feet are easily damaged when bare. Check shoes and socks for foreign objects which cause skin damage, and purchase well-fitting shoes.
- Heat. Check the temperature of water and avoid hot-water bottles. Heat sources can burn the skin if neuropathy is present.
- Skin care. Wash your feet daily and dry well between the toes to avoid athlete’s foot. Skin can get very dry; apply moisturising cream daily, except between the toes.
- Holidays. Apply sun cream to prevent burning and protect the soles of your feet from heat by wearing sandals. Take a small first aid kit to treat wounds and seek advice on your return if they don’t heal
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