by Christine Kemp (Practice Nurse – North Coast Vascular)
People with diabetes are very prone to ulceration of the feet, this is due to multiple effects that diabetes has on the body.
- Diabetes damages the peripheral nerves causing loss of sensation and inability to detect painful stimuli. Diabetes also damages the nerves to the sweat glands of the skin resulting in the skin being dry, cracked and ulcerated.
- Diabetes damages blood vessels which reduces the blood flow to the feet making any wound slow to heal.
- Diabetes reduces the body’s ability to fight infection which increases the risk and severity of wound infection.
- Diabetes causes deformity of the feet which can lead to points of high pressure which can lead to callus, skin breakdown and ulceration.
50% of leg amputations are associated with diabetes
85% of leg amputations in diabetes are preceded by a foot ulcer
History and examination should include: x rays, ultrasounds, CT/MRI, angiogram/angioplasty.
Regular foot care can prevent ulceration
Diabetics must inspect their feet daily. Thorough washing and drying followed by moisturiser is essential. Daily inspection of shoes for foreign objects is a high priority and shoes must be comfortable with good support and have no pressure points. Any podiatrist providing care must have excellent knowledge of vascular health.