Diabetic Foot Care: Role of a Podiatrist

Diabetes can cause several complaints and conditions like peripheral neuropathy (nerve damage that triggers pain and numbness in feet and hands), foot infection and ulcers, poor circulation (that impairs the body’s ability to heal) and stiffer joints.

In the domain of diabetes management, most patients do not consider foot care as a crucial aspect. They tend largely to leave unattended foot problems, until a serious condition develops. Having a podiatrist in the diabetes management team will help in preventing and managing related foot conditions in the following ways.

Spotting signs of danger early

Due to peripheral neuropathy, people with diabetes are slow to react to cuts, pricks, burns and bruises. They do not feel often any pain or discomfort caused by open sores or bleeding calluses and corns.

During regular scheduled check-ups, a foot doctor can observe such symptoms early and advice prompt treatment, before they worsen to a serious condition. A podiatrist can also notice red flags like skin color changes in the feet, numbness in toes or feet, pain in legs, sores that take too long to heal, swelling in the ankle or feet, ingrown/fungal toenails, dry cracks around heals etc., and prescribe a proper diabetic foot care management required.

Some diabetics may have existing medical conditions like arthritis, which can make foot conditions worse. Having a podiatrist on the diabetes management team in such cases will help address the condition more effectively, and prevent a possible toll on mobility.

Speedy healing of wounds

Injuries and wounds of diabetics often take longer to heal than those of a healthy person. In case the wound stays open, a diabetic is more prone to develop an infection than a non-diabetic is. Such untreated wounds and infections can turn into gangrene, and even infect the bones, increasing the chances of an amputation. However, with the right tips on foot care and treatment of a podiatrist, the wound/injury can heal faster.

Treatment and monitoring of ulceration to avoid amputation

Podiatric management of a diabetic ulcer starts initially with an evaluation of diabetic status and previous treatment history together with a diagnosis of the cause and the stage of the ulcer. A foot doctor examines further, if any infection is present, and the ulcer is ischemic, neuropathic, or neuroischemic.

When treating this vulnerable population, a podiatrist ensures a high level of infection control and plays a crucial role in timely treatment and monitoring of diabetic ulcers to bring down the chances of amputation.  The foot doctor chooses the most suitable cleansing solutions and dressing materials, prescribes topical ointments and uses off-loading techniques that include measures like felt padding, prescription insoles and orthotics.

A multidisciplinary approach is required to treat diabetic foot conditions. It is necessary that an experienced and reputed podiatrist works together with other healthcare professionals; helps in proper screening and assessment of the foot condition; offers timely, effective and speedy treatment; performs biomechanical and gait analysis; provides skilful clinical care; offers foot care education as well as footwear advice.

Diabetic Foot Care: 5 Important Tips

Diabetes can impair blood supply to your feet and trigger diabetic peripheral neuropathy (loss of sensitivity of nerves to pain, temperature, and pressure particularly in the legs and feet). Because of this, foot injuries take a longer time to heal; cuts, bruises or other foot injuries are likely to go unnoticed and untreated and get worse. Given below are five important tips for diabetic foot care.

1.Managing the condition

You should follow these steps assiduously to manage your foot health effectively: eating a balanced diet (rich in fruits and vegetables recommended), monitoring your blood sugar level, staying active and controlling weight gain with a regular exercise regimen, limiting your alcohol intake and quitting smoking. In addition, regular general health and foot health check-ups are crucial to recognizing red flags and taking prompt treatment.

2.Daily foot inspection

Check your feet every day to spot sores, cuts, corns and calluses, red spots, blisters, infected toenails and swelling. If you find any, attend to them promptly asking your foot doctor for advice. You can use a pumice stone to smooth corns and calluses, but don’t cut them as it can damage your skin and may even cause infection.

Remember to trim your toenails and seek help if you find them yellowish, thick or growing back into your skin. If you find it difficult to bend over and inspect your toes, you can use a mirror or ask your family to help. Every time you return home, make sure you wash your feet, dry them and inspect to see if they are clean.

3.Choosing the right footwear and socks

The right footwear that provides adequate support to your feet is crucial for good foot health. It’s best to buy shoes in the evening when your feet are at their largest – they do swell during the day; that would help you get a good fit. While buying, you should ensure that the shoes do not pinch your toes or feet, and the toe box is comfortable.

According to foot doctors, you should avoid wearing high heels or shoes with pointed toes that put undue pressure on your toes. For daily wear, flat walking shoes or athletic shoes would be a prudent choice. Just like shoes, the right socks too are crucial. Wear lightly padded, clean and good fit socks with no seams; that would help avoid walking barefoot and injuring your feet accidentally.

4.Avoiding barefoot walking

Walking barefoot and stepping on something that hurts or cuts could be dangerous, since you may not notice that your foot is hurt. Even while indoors, avoid going barefoot for all it takes to hurt your feet is a misplaced nail or a child’s toy. As you avoid going barefoot on hot pavements or sandy beaches, be on guard to take the same care when at home.

5.Seeking medical attention for foot ailments

Whether you experience numbness, unexplainable pain, or suffer injuries, cuts or bruises that refuse to heal, don’t try over-the-counter medicines. Consult your foot doctor for correct diagnosis of the cause and proper prescription of medications, taking into consideration pre-existing health condition, if any. You can even seek from your doctor foot care tips on special shoes and orthotic support for free and comfortable mobility.

With conscious follow-up action on these tips and periodical consultation with an experienced podiatrist, you can avoid foot ailments and enjoy perfect foot health, despite your diabetes.

Foot pain diabetes and the risks involved

People suffering from diabetes have a high risk of developing foot problems and diabetic infections in the feet and legs. Diabetes can cause damage to the nervous system of these patients, thereby making them go numb in the feet. So, such people are unable to feel any sensation in their feet even when they develop sores or infection, leading to a delayed treatment. Many cases even end up with serious gangrene or amputation. That’s why foot care should be an important part of life for a diabetic.

The foot is the part of the body most prone to injuries. As diabetics experience numbness in their extremities, they may have a foot injury and not realize it. Even something as simple as an ingrown toenail could get infected and cause a big problem for a diabetic. Doctors counsel diabetics to take care of their sugar levels to make sure that they do not reach a stage where they advance to neuropathic symptoms. 

Reasons that may cause foot problems in diabetics

 

There are various reasons why a diabetic could get a foot problem like a foot ulcer or other foot infections. Diabetic neuropathy is one reason where there is damage to the nerves supplying the blood to the feet. Peripheral vascular disease causes decreased blood flow to the feet also resulting in numbness. A person who has been diabetic for ten or more years has more chance of foot problems. Smoking, alcohol and a bad diet could all trigger foot problems in a diabetic. If the diabetic is not managing their blood sugar levels, it could give rise to foot infections. Continuous trauma to the feet in the form of corns and calluses is not good for diabetics. If the diabetic already has a genetic predisposition towards foot problems or has foot bones that are deformed or suffers from bunions, they are at a risk for foot ulcers and infections. Thick or ingrown toenails can cause foot infections. 

How to take care of your feet if you are diabetic 

A wound takes a long time to heal in a diabetic. So a diabetic should take extra care when walking or running. Wearing shoes or covered footwear can lessen the chances of getting injured. But it also opens a Pandora’s box of other problems. Enclosed footwear is a breeding place for bacteria and so if you wear covered footwear all the time you could get an infection. The best thing to do is to find the right balance between both. Wear covered footwear to protect your feet, but take them off and air your feet every now and then. There is also anti fungal powder that is available and can be used to powder your feet at regular intervals. This prevents foot odor too. 

There are various products available for diabetics to keep foot problems at bay as well to help deal with them. There are topical creams that help ease foot pain and tablets that relieve symptoms of diabetic neuropathy like tingling, burning and numbness. It is very important for a diabetic to insulate their feet against cold weather as this aggravates foot problems. Very well made diabetic foot socks are available to combat the cold. You can get foot lotions, creams and sanitizers that will go a long way in keeping your feet free from infections. 

A regular check up with a podiatrist is necessary if you suffer from diabetes. As they say, ‘Prevention is better than cure’. By taking a few simple but important measures you can lessen the risks caused by diabetes.