Diabetic Foot
Diabetic Foot
Description
Fluctuations in blood sugar levels associated with Diabetes can, among other things, impair the body’s vascular (blood flow) and nervous (sensation) systems. These impairments can predispose a person with diabetes to foot ulcers (pressure wounds), bone damage (charcot events) with related infection and in advanced cases, can lead to amputation. Impairment of blood flow and nutrient delivery to the lower extremity can compromise the body’s ability to heal itself.
Impairment of the nervous system can result in the loss of feeling/ sensation in the feet making it difficult to feel the discomfort or pain that would indicate a problem like an area of high pressure or small wound like a blister. Diabetes can also deprive vital nutrients from the bones of the feet resulting in fractures called ‘Charcot events’. Poor quality footwear, poor shoe fit and some foot deformities can increase the risk of ulceration and infection.

Symptoms

  • Because feeling is often impaired, it is difficult for individuals with diabetes to know there is a problem under foot.
  • Daily visual inspection is critical - areas of redness, swelling or heavy callusing should be monitored closely as should any signs of infection like fever, nausea, or strong odor from one’s feet.
  • At the first sign of a problem people with diabetes should seek immediate medical attention.
  • People with diabetes who have a history of ulcers or slow healing wounds should be under the regular care of a podiatrist or other qualified foot care specialist.
Pedorthic Management
  • For people with no ulcers, custom foot orthotics may be prescribed preventatively to re-distribute pressure over the bottom of the feet and/or to reduce pressure in high risk areas or previous wound sites.
  • For people with active ulcers, custom foot orthotics and/or wound healing shoes may be prescribed to re-distribute pressure over the bottom of the feet and unload pressure directly under the ulcer site.
  • Supportive footwear that is torsionally stable (can’t be folded or twisted easily) to protect your foot from problems you may not feel. Footwear should be fitted professionally to ensure that it is not too tight or too loose.
  • Orthopedic modifications to footwear to increase support, decrease pressure and promote healthy gait.
  • Seam-free, non-cotton socks to wick moisture and prevent skin irritation and breakdown.
Other Treatments
  • Please consult a qualified diabetes health care professional for information and advice regarding other treatment options.