DIABETES MELLITUS (DM) is known as the silent disease, and is reaching epidemic status worldwide. According to Diabetes UK, there may be 40 million people in England alone who do not realise that they have diabetes.
There are two types: DM 1 and 2. Type 1 occurs when the pancreas stops producing insulin – it is vital for survival that the patient uses daily injections of insulin to remain healthy. With Type 2, the pancreas is still producing some insulin but it may not be enough or the body is rejecting it. This can be treated with medication and a change in diet.
Diabetes, if left untreated and uncontrolled, can be destructive, causing many problems to the major systems of the body. This is when the disease becomes apparent and many patients are ‘suddenly’ diagnosed as being diabetic.
An area of the body that is not usually associated with illness is the feet. For the best part of time, they are neglected unless they become painful or need to be put on show in a strappy shoe. Diabetic feet need a bit more care and attention to keep them in a healthy and beautiful state.
DM can affect the blood supply to the feet, causing poor circulation that leaves them vulnerable to infections and slows down the healing process. The nerves can also be affected and, because the changes have taken a long time to occur, patients may not be aware that they do not have any sensations in their feet – this is called neuropathy. Pain is a warning sign and feet that cannot feel pain are more at risk, as injury and infection can go unnoticed.
In the older patient, neuropathy affects the function of the tiny intrinsic muscles of the feet, causing the toe digits to buckle, resulting in hammer and clawed toes. Footwear can become a problem when there is no pain sensation to warn of rubbing and friction from the shoe and what was a simple blister can become an ulcer. These are a few ways in which DM can affect the feet, but, with care and attention, these risks can be minimised.
Good control of the diabetic state and a positive attitude to self care can make a very big difference. Your feet were designed to last a lifetime and, with a bit of TLC, they should do just that.
Foot care tips
• Protect your feet. Never walk bare foot and wear comfortable shoes that fit well.
• Check footwear for foreign objects.
• Don’t use hot water bottles or heat pads.
• Keep your blood sugars within a good range.
• Check your feet everyday for cuts, red spots, blisters and swelling.
• Wash your feet in warm, not hot water. Dry your feet well, especially between the toes.
• Always moisturise your feet to keep the skin supple, but not between the toes, and avoid hard, dry and cracked skin.
• If you can see and reach your toenails, trim them straight across and file the edges with an emery board.
• Keep the blood flowing. Wiggle your toes and move your ankles up and down for five minutes, two or three times a day.
• If you discover anything on your feet that you are not sure of, always refer to your doctor for advice.
Begin taking good care of your feet today for a lifetime.
Anne Bull, BSc Hons. in podiatry