Diabetes is a chronic disease that causes high blood sugar due to the pancreas not producing enough insulin or when the body cannot effectively use the insulin it produces. The high blood sugar in diabetes may cause damage to various parts of one’s body, such as the nerves, blood vessels and skin. Such complications are often seen at the unbeknownst Diabetic Foot Ward at Mater Dei Hospital with the following conditions:
Peripheral Neuropathy is a condition in which excess blood sugar damages nerves in the foot. This leads to numbness and tingling in the feet, burning, stabbing or shooting pain in the affected areas, loss of balance and coordination as well as muscle weakness. MHSA’s Podiatry students have this complication particularly close to heart as they have volunteered to test the general public’s is peripheral sensation, time and time again.
Peripheral Vascular Disease involves the blockage of blood vessels around the body due to fatty deposits. This blockage results in blood flow, especially to the extremities, to be significantly reduced. This diminished blood flow can cause pain on activity, due to reduced oxygen flow to muscle tissue, thus leaving the individual unable to walk long distances as well as experiencing excruciating pain while lying down in bed, at a more serious stage.
Ulcerations are commonly associated with diabetes, since people suffering with the conditions described above are often predisposed to wounds which fail to heal adequately. Around 15 to 20% of diabetic patients develop a foot ulcer at some point in their life, hence it is important that the patient visits a podiatrist if they notice the development of abnormal changes in their feet.
Practical tips to prevent uncontrolled diabetes and further foot complications include:
● Regulate Sugar Intake: One could avoid or else control diabetic foot complications by decreasing sugar consumption. This includes both complex sugars such as refined pasta and bread, as well as simple sugars as in chocolates and carbonated drinks.
● Stay Active: Fortunately or unfortunately, exercise is the solution to everything as exercising regularly will not only decrease blood sugar due to an increased metabolism, but also promotes blood flow to the feet, combating the circulatory complications of diabetes.
● Wear Appropriate Footwear: Protection of the feet in socks and shoes at all times is recommended by podiatrists, as is the use of the use of cotton socks which do not obstruct circulation. Poor footwear is not excusable in foot deformities as a podiatrist can recommend custom made shoes to help prevent future and accommodate present deformities. For further information please refer to the next point…
● See your Podiatrist Regularly: Regular examinations by a podiatrist are key to preventing infections, amputations, severe deformities and to maintain overall good foot health. This is offered free of charge to diabetic patients around Malta and Gozo at primary health centres. This examination includes an overall assessment of the feet’s skin and nail quality, circulation, mobility and skin sensation. This will ensure that your feet are in top shape and control the diabetic manifestations.
● Check Your Feet Daily: A daily self-foot examination can be done by checking the skin of the foot particularly at the sole, toes and in between the toes for visible abnormalities. Not being able the bend down has been made easy in the 1830s with the revolutionary invention of the mirror.
● Maintain Good Foot Health: One can start off by carefully trimming the toenails straight across and keeping them just above the free edge to prevent ingrown toenails and infections. Washing and drying the feet well, especially between the toes prevent the possibility of infections. One should also protect the feet from extreme temperatures as exposure to extreme hot and cold can damage the diabetic foot. Therefore, it is not advised that a diabetic patient checks the water temperature in the shower using their feet, as the impaired skin sensation could lead to skin scalding.
According to The International Working Group on the Diabetic Foot, globally, every 20 seconds a leg is amputated due to Diabetes, this means that by the time you have read this article approximately 18 leg amputations have been performed. We hope that we have convinced you to regularly check out your feet and not mouth-watering, crispy (but fluffy) chocolate covered fresh donuts!
Written by: Maria Abela and Federica Bartolo