Diabetes - Foot Management & Care

With any foot related concern, person with diabetes should seek advice or a consultation from their family physician, chiropodist or podiatrist. It is not necessary to obtain a referral from your family physician if you require the services of a chiropodist, although we do inform the physician of any relevant information.

At the Ashburnham Foot and Ankle Clinic we designated high priority to diabetic foot health.
This component of our clinic has arisen as a result of the increasing demand for quality comprehensive foot management in the Peterborough and surrounding area.

At our clinic, the focus is on four main areas of management.

1. Education

Complications of diabetes and how they affect the feet (Specific needs relating to individual requirements).
Foot health education and the importance of foot care.
Footwear and orthotic devices.
The various services available at the chiropody department
Other services, eg. C.D.A, dietetic counselling, etc.

2. Prevention

Medical history, specifically relating to diabetes.
Podiatric assessment
Vascular testing using Doppler ultasound equipment.
Neurological (nerve) testing
Biomechanical assessment (the effects of structural problems and how they relate to foot health)

3. Treatment

Appropriate treatment of foot problems ( eg. ulcer debridement, nail surgery, orthotic management or nail and corn/callous treatment).

4. Follow-up

All newly diagnosed and current diabetics are encouraged to have regular follow-up consults for the purpose of reinforcement of preventative footcare and monitoring changes, sometimes subtle, within the feet.

We recommend that all persons with diabetes receive at least one consult to have their feet assessed. Remember, prevention and early detection of foot and leg problems is essential in order that complications can be minimised or avoided.

Good Foot Health For All Persons with Diabetes

All newly diagnosed and current diabetics are encouraged to have regular follow-up consults for the purpose of reinforcement of preventative footcare and monitoring changes, sometimes subtle, within the feet.

We recommend that all persons with diabetes receive at least one consult to have their feet assessed. Remember, prevention and early detection of foot and leg problems is essential in order that complications can be minimised or avoided.

The human skin is the largest organ of the body. Its structure varies greatly between different locations, especially within the foot. For example, the skin on the top (dorsum) of the foot is thin with occasional hairs as compared to the bottom (plantar) of the foot which is thick and hairless. The reason for this is that skin is required to perform many different functions. These include:

.......- Regulation of surface and body temperature,
.......- Provide nutrition to its many appendages (eg. sweat glands, hair follicles),
.......- Act as a barrier to potential infections and injury from trauma,
.......- Have a sensory function (eg. temperature, pressure)

For the skin to function efficiently, it must be healthy enough so as to counteract potential problems. Once reduced blood circulation and sensation affect the skin, as is often the case with diabetics, the potential for local as well as systemic problems is greatly increased. It is therefore essential for persons with diabetes care for their skin properly, taking the necessary action to minimize complications.

1. Inspect the feet daily checking for any signs of injury or foreign bodies (eg. a dog's hair or splinter) on/below the skin surface.
2. Good foot hygiene includes washing the feet daily, however soaking is not advised, as the skin becomes much more susceptable to risk from infection and trauma. Use a thermometer if necessary to test if the water temperature is correct, about 40C/104F.
3. Use a mild, unperfumed soap and wash gently. Other kinds of soaps may be irritable, or excessively drying to the skin.
4. Dry your feet carefully, particularly between the toes.
5. Do not expose the feet to extremes of heat and cold.
6. If the skin appears dry and scaly, a mild unperfumed emollient cream may help moisturise the skin. If the skin is cracking , peeling or showing other unusual signs, consult your physician or chiropodist for advice.

There are many different kinds of lesions that can develop on the skin,( eg. a corn or callous, plantar wart):

NEVER attempt to treat these yourself or allow a well meaning friend or relative to treat it. Many of the diabetic foot complications seen in chiropody clinics are a direct result of "home treatments".

NEVER use medicated corn plasters or caustic medications unless prescribed by a physician or chiropodist. These preparations can cause extensive damage to skin and other tissues.

NEVER walk barefoot even in your home, objects such as wood splinters or animal hairs can easily penetrate the skin undetected if a diabetic has any sensory neuropathy (loss of sensation).