12 Welles Street, Sandbach,
Cheshire, CW11 1GT
01270 76 77 44
The Diabetic Foot
Diabetes is a chronic illness that needs regular monitoring by the person living with diabetes and a multi-disciplinary team including a podiatrist. It develops if the body becomes resistant to insulin or the pancreas becomes unable to produce enough insulin. This causes an increase in blood glucose levels as the job of insulin is to move glucose from the blood stream into your cells.
Type 1 and Type 2 Diabetes are NOT the same disease. ​
​
Type 1 Diabetes is an autoimmune condition. Only 1 in 10 people with Diabetes have Type 1 and often this develops in childhood. It is treated with insulin.
​Type 2 Diabetes is an endocrine condition (related to hormone production).
Insulin is a hormone. People with Type 2 Diabetes do not produce enough insulin or enough effective insulin. Type 2 Diabetes can be treated through dietary and lifestyle changes, medication or if necessary, insulin.
Increased blood sugar levels can cause high blood pressure and narrowing of the blood vessels and as the legs are the farthest part of your body from your heart, the blood vessels in your feet can be the first to be affected. Likewise, the long nerves that reach your feet can be the first to be damaged by high blood sugar levels. ​
​
Ideally people living with Diabetes will attend a podiatrist regularly (every 6-8 weeks) for foot and nail care and self-care is important here too. Being aware of what is ‘normal’ for your feet is important in early detection of lower limb problems that can escalate quickly; a cut can become infected due to high blood glucose levels, a crack in the skin can become fungal which can become chronic and painful and peripheral neuropathy can mean that you are unaware of the problem.
​
Once a year it is important to have an Annual Podiatric Diabetic Assessment this includes a vascular and neurological assessment. A medical history, case history and visual assessment is also part of this, the report of which allows monitoring of your lower limbs and the results are communicated with your GP.
Long term complications of Diabetes in the lower limb can affect the circulation to the feet and legs causing cramps, restless legs and poor oxygen levels to the skin and muscles. It can also cause damage to the long nerves that reach your feet. This can mean a loss of sensation (peripheral neuropathy) or heightened sensation (painful neuropathy).