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Diabetes foot check

Dr Karen Martin
Reviewed by Dr Karen MartinReviewed on 19.10.2023 | 5 minutes read

Diabetes mellitus is essentially a problem with keeping your blood sugar in check, and this can have far-reaching consequences from head to toe. Your feet are at particular risk for a number of reasons, and they are checked every year in your annual diabetes check-up. This ensures that any problems are found early and addressed.

Why do diabetics have foot checks?

Diabetes mellitus, a chronic metabolic disorder characterized by high blood sugar levels, can have significant implications for foot health. Individuals with diabetes are at increased risk of developing complications related to circulation and nerve damage, making regular foot checks essential for preventing serious issues such as infections, ulcers, and even amputations.

Diabetes affects circulation in the lower legs and feet by reducing blood supply to these areas. This diminished circulation compromises the body's ability to heal effectively, making individuals more prone to cuts, sores, and wounds. Moreover, reduced blood flow can lead to tissue damage and slow the healing process, increasing the risk of infections and ulcers over time.

In addition to circulation issues, diabetes can also impact nerve function, a condition known as diabetic neuropathy. Nerve damage can result in decreased sensation in the feet, making it difficult for individuals to detect injuries or wounds. As a result, minor foot problems such as blisters or cuts may go unnoticed and become infected, leading to more severe complications.

Furthermore, high blood sugar levels associated with diabetes create an ideal environment for bacteria, fungi, and yeast to thrive. This can lead to further complication like athletes foot and cellulitis. These microorganisms can cause infections and exacerbate existing foot issues, further increasing the risk of complications.

Regular foot checks are essential for individuals with diabetes to identify potential problems early and prevent the progression of foot complications. Healthcare professionals, including doctors, podiatrists, and diabetes nurses play a crucial role in conducting comprehensive foot examinations, assessing circulation and nerve function, and providing guidance on proper foot care practices.

Preventive measures such as foot care are very important. Wearing comfortable, well-fitting shoes, maintaining good foot hygiene, and avoiding walking barefoot can help reduce the risk of foot injuries and infections. Additionally, individuals with diabetes should prioritize blood sugar control through diet, exercise, medication, and regular monitoring to minimize the risk of complications affecting the feet.

In conclusion, foot checks are vital for individuals with diabetes to protect against the serious consequences of foot complications. By prioritizing foot care and adopting preventive measures, individuals can maintain optimal foot health and reduce the risk of amputations and other severe complications associated with diabetes-related foot disease.

What happens at a foot check?

Your appointment will most likely be with your regular doctor or diabetes doctor. They will ask you to take off your shoes and socks or tights and expose to the knee. They will carefully examine the skin for any skin breakdown or ulcers, and they will test the nerves by whether you feel their touch and they will test for the foot pulses. They will talk you through any findings after your foot check.

They will grade your risk as low, moderate, or high. Those with moderate or high risk will be referred to a foot specialist called a podiatrist for further checks.

You will be given advice about how to look after your feet, signs to watch out for and how to reduce the chance of developing significant disease.

This is one part of your annual diabetic check-up, which also includes eye screening, blood tests, blood pressure, weight, and your own rating of how diabetes is affecting your quality of life.

What are concerning signs in the foot?

Keep an eye out for signs of acute infection – redness, pain, pus – especially if you have an insect bite, open sores or cracks in the skin. Fungal infections could start as smelliness, flaking, itching, and slightly red areas. Fungal toenail infection will give thickened, crumbly, yellowish nails - and one toenail can affect the others.

Signs of a nerve problem include pain, numbness, tingling, burning, or you may notice a wound or blister that seems a bit numb rather than painful.

Leg cramps, especially when walking, dry red flaky skin on the lower legs, or any color change or swelling to the lower legs, ankles or feet may suggest a circulation problem. Changes to the color or sensation of a toe will need urgent assessment.

For any of these symptoms, you should contact your doctor or specialist diabetic team, if you have one, to have an assessment of your legs. This might need urgent assessment, depending on how quickly the problem has developed.

How can I prevent foot problems from developing?

Managing your foot health means moisturizing your feet daily to maintain the skin barrier, and prevent dryness and sores from developing. It’s important to look after your toenails, as these can cut into the skin on other toes if they get too long, making you prone to fungal infection, which can also affect the skin (tinea pedis).

Choose nail clippers to cut the top of your nails regularly and use nail files if necessary at the sides.

Avoid the use of anything that can damage the skin of your feet like sharp objects, corn plasters or blades. It is very important you wear well fitted comfortable shoes to prevent blisters and sores from developing on your feet, and it will also help you on your way to keeping active to combat diabetes.

Feet are at risk from other problems, so to keep them in the best condition, this is the time to address other risk factors. Smoking is detrimental to so many of the body’s systems, but it particularly contributes to a buildup of plaque in the blood vessels, risking a blockage to the feet. High blood pressure and high cholesterol have similar effects on blood vessels. Excess alcohol over a long period can affect the nerves to the feet, causing peripheral neuropathy. Finally, eczema can cause problems with the lower legs and feet, so make sure you keep this under control with heavy moisturizers and prescribed creams when needed.

Finally, for preventing any complications from diabetes, you are committing yourself to a lifetime of taking your prescribed medications, eating a healthy well-balanced diet, keeping obesity at bay and exercising regularly.

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This article has been written by UK-based doctors and pharmacists, so some advice may not apply to US users and some suggested treatments may not be available. For more information, please see our T&Cs.
Dr Karen Martin
Reviewed by Dr Karen Martin
Reviewed on 19.10.2023
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