Put your best foot forward for better diabetes care
Every year in Australia, 4,400 amputations occur as a result of diabetes – 85% of which could be prevented through better care of the foot, toes and lower leg.
Neuropathy, or loss of feeling, is common among those with diabetes. People with all types of diabetes experience neuropathy, and in some cases people can discover they have diabetes as a result of foot problems. When this occurs in the foot people can be unaware of damage slowly developing such as skin issues including blisters and ulcers, or small fractures of the foot bones which if left untreated can turn into a charcot deformity where the bones of the foot collapse.
In advanced cases of infection or charcot deformity, the patient may need to have toes or foot amputation surgery. However, with early awareness and good foot hygiene this can be avoided.
Orthopaedic surgeon Dr Anthony Cadden offers these tips on foot care for diabetes:
Get to know your feet. Examine your feet daily, particularly if you start to notice you are losing the sensation. Look for signs that a callous is forming, or there’s a risk of ulceration or there’s been a change in the shape of the foot.
Always wear appropriate footwear, even in the house, to minimise the trauma to your feet. An example would be leather style shoes without seams. These should be appropriately fitted so that you don’t get movement in the shoes that cause friction and blisters.
And how do they know what to get your feet into? This is where regular podiatry review comes in. A podiatrist will do all the testing to see if you have sensation and get rid of any callouses that can occur.
Finally, the big one that often gets missed is the diabetic who turns up to the GP with the red-hot swollen foot. They get commonly diagnosed as having cellulitis, however it is important for the patient to have a good understanding of other common diabetic foot problems in the event that the problem persists or begins to appear in the other foot. The patient can then raise the issue with their GP who might change their course of treatment.
If we are able to recognise it early, and it’s a non-surgical treatment, ie. immobilisation, to allow the fracture then to heal, that could then potentially reduce that risk of the collapse and the ulceration, infections, hospital admissions, and amputations from occurring.
Because if you can prevent that from occurring, not only is it saving a limb, it also saves the health system. Such conditions can have an impact on patients and on the health system and high-risk diabetic clinics for these people to continually have dressings, admissions, antibiotics, surgery, which may not be required. Diabetes-related foot disease costs Australia around $1.6 billion each year imagine what else that could be spent on.
Diabetes Australia has developed a program called Foot Forward, with easy-to-understand information on foot care, examination and avenues for further care at www.footforward.org.au.