Diabetes

Diabetes is caused by high levels of sugar in the blood. There are two main types of diabetes – type 1 diabetes and type 2 diabetes.
 

Type 1 diabetes
This can develop at any age, but usually appears before the age of 40, particularly in childhood. Around 10% of all diabetes is type 1.

Type 2 diabetes
Here, the body either doesn't produce enough insulin to function properly, or the body's cells don't react to insulin. Around 90% of adults with diabetes have type 2.

Because of the way diabetes can affect sensation and circulation, people with the condition are at much greater risk of developing problems with their feet. If these problems are left untreated, they can cause foot ulcers and infections and, at worst, may lead to amputation. However, with good, regular foot care, most foot problems are preventable. A quality foot check from a properly trained person at least once a year is recommended.

There are two principal ways that diabetes can affect feet:

Nerve damage 
When diabetes causes nerve damage, doctors call it diabetic neuropathy. This can result in loss of feeling in the feet to the extent that they can be damaged without the patient knowing. For example, a cut or sore might go unnoticed, become infected and develop into an ulcer. Nerve damage can also affect glands and make skin dry and tight. This can make the skin crack, which can result in infections.

Circulation problems 
Poor glucose control can also affect the circulation in your feet. When this causes the arteries that supply the feet with blood to get narrower, it’s called peripheral vascular disease, and means that cuts and sores don't heal easily. It can also cause cramps and pain.

People with both diabetic neuropathy and peripheral vascular disease, are at particular risk of foot infections. This is because they can injure their feet without knowing and these injuries then don't heal. Some people with diabetes get such bad infections that they need to have their toe, foot, or even a leg, amputated.

The good news is that most problems can be prevented with regular care of the feet. Here are some tips on how to do this:

  • Check your feet every day for any problems such as cuts, blisters or sores
  • Wash your feet every day and dry them well, particularly between your toes. If you have dry skin, use lotion on your feet afterwards.
  • Gently file corns and calluses (areas of thickened hard skin).
  • Cut your toenails regularly.
  • Wear slippers or shoes to protect your feet from injury – remember you might not feel any pain if you step on something sharp.
  • Wear socks or tights to prevent blisters.
  • Wear shoes that fit your feet well.