WHEN it comes to how diabetes can affect the feet, poor circulation and poor nerve supply are two of the main problems that may occur.

NEUROPATHY

Poor nerve supply leads to a loss in sensation, which usually starts at the toes. Patients often describe it as a cotton wool-like feeling or numbness. This is called neuropathy. At least one in three patients who are diabetic will have this condition. The longer you have had diabetes, the greater the chances of losing sensation in your feet. Patients are often unaware of it when it first starts as it can be very gradual.

The loss of feeling in the feet can lead to a patient damaging them unknowingly. You could stand on a sharp object and not feel anything or burn yourself in the bath by not being able to tell how hot the water is. If left untreated, this can potentially lead to serious consequences and possible amputation. This frightening outcome is far less likely if you seek the expert advice and regular treatment from your podiatrist.

Some patients suffer with “painful” neuropathy. They may feel sharp, stabbing or burning sensations in their feet. This often worsens at night. There is advice and medication your podiatrist or doctor can recommend to reduce the symptoms.

POOR CIRCULATION

Diabetes may also affect your circulation leading to an increased risk of infection, ulcers and poor wound healing. Inefficient blood supply may manifest as cold feet, a lack of hair growth on the toes and legs, swollen feet, and discoloration of the skin.

REDUCE YOUR RISK

To reduce the risk of ulceration and amputation, follow these rules:

Do not smoke.

Control your blood sugar. Be careful with your diet and what you eat. Seek advice from your podiatrist, doctor or dietician. Have your glucose levels checked regularly to ensure they remain within the correct margins. Too much sugar in your blood will accelerate the risk of foot and other diabetes-related problems.

Examine your feet daily for any sores, cuts or bruises. Get your family to help you if you can’t get down to them yourself.

Wash your feet daily and dry between the toes carefully. Do not use foot spas as soaking your feet for long periods of time can make the skin fragile and dry. Foot spas also tend to harbour bacteria.

Use lotion and creams on your feet daily, but avoid between the toes. Use a bland, unperfumed lotion if possible.

Choose well-fitting shoes that are supportive, with a lace or strap. They should be spacious enough to wriggle your toes around. Try to buy leather and always check inside your shoes before putting them on.

Cut your toenails by following the curve of the nail and don’t cut them too short or deep down the sides. If you are unable to cut your nails yourself, do not go to a nail salon, but visit a podiatrist or medical professional trained in diabetic foot care to have it done.

Never use over-the-counter corn or hard-skin remedies. All corns should be removed by a medical professional.

Cross your legs at the ankles, not at the knees.

Never walk barefooted, even inside the house.

If you have a cut on your foot or any other part of your body and it

is not showing significant signs of healing within 48 hours, seek medical help.

Attend the podiatry clinic at least every three months for check-ups. As well as treating your general foot problems and giving advice, the podiatrist will check your nerve and blood supply to make sure they are satisfactory.

Follow all these rules and you should be able to avoid the nastier side of the diabetic foot. It may seem like a lot to adjust to, but remember, when you lose a limb, there is no turning back.

Angela Davis BSc (Hons) DPodM MChS is a podiatrist with offices in Montego Bay, Mandeville, Ocho Rios, and Savanna-la-mar. She is a member of the Health and Care Professions Council in the United Kingdom. Contact her at 293-7119.