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Diabetes is a condition where the production of insulin in the pancreas is affected.
Insulin is an important chemical that our bodies use all the time to regulate blood sugar levels. Insulin is needed to allow glucose in your blood (from the food and drink we consume) to pass into the cells of the body where it can become energy. This is a really important process.
Type 1 diabetes is often associated with younger people and is when your pancreas cannot produce any, or enough insulin.
Type 2 diabetes is often associated with adults and can be linked to obesity, diet and stress. In type-2 diabetes, your body cannot or does not use the insulin it produces.
Gestational Diabetes is a type of diabetes that occurs during pregnancy.
Diabetes usually results in high blood sugar levels, which, when untreated, can cause many health problems.
In the feet, it can lead to impaired sensation or feeling due to nerve damage (diabetic neuropathy) and associated impairment of the circulation or blood flow to the feet.
Peripheral neuropathy is characterised by damage to the nerves that serve the feet and other extremities of the body. In the feet, this can lead to numbness, altered sensations or even pain and heightened sensitivity. Peripheral neuropathy can place the feet at more risk because you could injure the feet, skin or nails and not realise. As a result, you can keep walking normally on an injured foot, or develop an infection or foot ulcer that you cannot feel.
If you have peripheral neuropathy, making sure that you check your feet regularly is important, using a mirror if needed to check the soles of the feet. Checking inside your footwear every time you put them on is important too, to check for any objects or damage to the footwear that could injure your feet.
It is also important to make sure that your footwear is not too tight, as many people with neuropathy tend to wear their footwear tight as they cannot feel it, so assume it is loose. This can cause pressure on the skin and nails and lead to serious problems.
It is advisable to avoid extremes of temperature on the feet too as you are unable to feel if the feet get burned. Hot tiles or hot sand when on holiday is a common cause of injury, and checking bath water temperature by dipping the toe in is risky too, because the nerve damage means that your toe won’t sense the hot water and you could plunge your body into a boiling hot bath. Using a thermometer may be a way to avoid problems here.
Nail and skin care needs to be considered more carefully if you have neuropathy too, so seeing a Podiatrist may be a good idea to get advice and help.
How do Podiatrists help?
As Podiatrists, we normally deal with problems associated with type 1 and type 2 diabetes.
Podiatrists play a pivotal role in the management of the diabetic foot from completing neurological and vascular assessments to check for nerve damage and impaired blood supply, to offering basic advice on foot care and helping with treatment of skin and nail problems.
Many Podiatrists also specialise in the management of foot ulcers related to diabetes which can be very difficult to heal and often require specialist management techniques, dressings and offloading of the area with foot orthoses or footwear.
If you suffer with diabetes, it is a good idea to get your feet checked regularly to keep an eye on any changes that could be occurring.
Video of a neurological assessment by a Podiatrist Coming soon
Video of a vascular assessment by a Podiatrist Coming soon
Another complicated condition linked to diabetes is Charcot Foot. Charcot foot is characterised by heat and swelling (in the early stages) then damage and deformity of the bones and joints of the foot. It is mostly associated with diabetic neuropathy but there are cases of it affecting people with nerve damage who are not diabetic.
This is not to be confused with Charcot-Marie-Tooth disease which is a neurological problem that causes peripheral nerve damage.