What do I need to know about diabetes and footcare?

Find out more about diabetic foot and how to take care of your feet when you have Type 2 diabetes.

January, 2021

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People with diabetes sometimes lose feeling in their feet. Doctors call this peripheral neuropathy. Peripheral neuropathy is nerve damage caused by high blood sugar and diabetes over a prolonged period. It leads to numbness, loss of sensation, and sometimes pain in your feet, legs, or hands.

 

Sometimes it can lead to more severe complications such as ulcers. In some cases, it may even result in toe, foot, or leg amputations.

 

Luckily, there are lots of things you can do to look after your feet and avoid problems. Issues like diabetic foot happen when the condition is not managed well so it is important to take care of your diabetes and your feet.

 

Why is footcare so important for people with Type 2 diabetes?

Every cell in the body needs a ready supply of oxygen and nutrient-rich blood to repair and maintain itself, but diabetes reduces blood circulation, meaning it can take longer for sores to get better.

 

Diabetes can cause peripheral neuropathy. It can result in people losing the feeling in their feet. It means people might not notice a stone in their shoe, or feel a blister. Untreated cuts and sores can get infected and become ulcers.

 

People with diabetes are also at a higher risk of gangrene than the general population. Gangrene is a state in which a certain part of the body is not getting sufficient blood circulation, causing the tissue to die.

 

Doctors might recommend surgery to remove the damaged tissue, and antibiotics to treat any underlying infection. In severe cases, surgeons might need to amputate the toe, foot, or even the whole lower leg.

 

In the UK, diabetes leads to 169 amputations every week. But there are lots of things you can do to prevent foot complications.

What are the signs of diabetic foot?

The symptoms of peripheral neuropathy are usually constant. For some people, they may come and go. People with diabetes are at a higher risk of developing the condition than those who do not have diabetes. Things to look out for include:
  • numbness in the feet
  • tingling in the feet
  • muscle weakness in the feet
  • a burning, stabbing, or shooting pain in the feet
  • loss of balance
  • loss of coordination
  • cuts or sores on the feet that do not heal

What are the signs of gangrene?

  • redness and swelling
  • loss of feeling or severe pain
  • sores or blisters that bleed
  • sores or blisters with a foul-smelling discharge, or pus.

How can I take care of my feet?

Long-term foot complications can be serious. But there are lots of things you can do to care for your feet and avoid problems like gangrene.

Lifestyle changes

One of the most important lifestyle changes is to stop smoking. Much like diabetes, it reduces blood flow, putting you at an even higher risk of foot issues.

 

You should also do your best to manage your blood sugar levels, cholesterol, and blood pressure.  Eating a balanced diet and staying active is a key part of this.

 

Having more fruit and vegetables while cutting down on fried foods, sweets, and sugary drinks can help you manage your condition. Regular exercise, whether it is running, walking, or gardening, is also important.

 

Of course, lifestyle changes can be difficult. But diabetes healthcare teams can offer lots of help and support. They can put you in touch with local smoking cessation services, or help you to make a healthy eating plan, for example.

Footcare

Taking a good look at the feet at least once a day – and speaking to a doctor if there are any changes – is a good idea. By spotting problems early, you can prevent them from getting worse. If you are unable to lift your legs high enough to do a daily check, then you could try using a mirror or asking someone to help.

 

Diabetes UK offers a range of practical tips on foot care for people with diabetes. These include:
  • keep the feet and toenails clean by washing them every day with soap and warm water
  • avoid soaking the feet, as this can make them soggy and vulnerable to damage
  • cut the toenails regularly
  • do not cut toenails too short or down the sides as this can lead to ingrown toenails and make problems worse
  • never wear shoes or socks that are too loose, too tight, or that rub. This can lead to blisters and sores that could develop into bigger foot problems
  • moisturise the feet every day, but avoid putting cream between the toes
  • never use corn blades or corn plasters. These can damage the feet.

When should I see a doctor?

The key to preventing serious foot problems in diabetes is early treatment. If you spot a change in your feet during your daily foot check, you should speak to your diabetes team as soon as you can.

 

The sooner peripheral neuropathy is diagnosed, the better. Doctors can recommend treatments and offer footcare advice.  If you suspect you may be developing the condition, you should tell your doctor or nurse.

 

Gangrene is very serious and needs urgent medical attention. It is irreversible, but doctors can stop it from getting worse if they know about it quick enough. Early treatment can prevent the need for amputation.

 

Diabetes UK also recommends that everyone living with diabetes attend their annual foot check with their healthcare team. These appointments are free on the NHS.

 

In England and Wales, the foot check will usually happen as part of the annual diabetes check-up. The doctor or nurse will ask you to take off your shoes and socks, then examine your feet and ask questions. They may also use a special piece of equipment to measure any numbness.

 

Afterwards, the healthcare professional will grade your risk of foot problems. It might be low, moderate, or high. Those in the moderate or high-risk groups might be referred to a foot specialist or podiatrist.

 

However, you should never wait for your annual check to raise any concerns. Time is of the essence in diabetes foot care. You should speak to your diabetes doctor or nurse as soon as you can if you:
  • notice any changes in their feet
  • suspect they may have peripheral neuropathy
  • suspect they may have gangrene