Diabetics must take good care of their feet
By: Noimot Olayiwola | Septmeber 28, 2013.
Diabetics are putting themselves at high risk of loosing one or both their feet if they do not take good care of them, Hamad General Hospital’s Podiatric Services head Dr Talal Khader Talal has cautioned.
The Podiatry clinic in Doha sees about 70 patients a day, including a large number of people with diabetes.
“If diabetic patients don’t take good care of their feet, they are putting themselves at high risk of losing one or both feet. If they see any foot injury, they should come directly to the clinic for treatment,” Dr Talal said.
Diabetes damages the small blood vessels that feed the nerves in the extremities, particularly in the legs and feet. This leads to a loss of sensation in the legs and feet, a condition called diabetic neuropathy.
For people with diabetic neuropathy, limited, or no sensation, means cuts, blisters or abrasions often go unnoticed.
People with diabetic neuropathy are also prone to injuries caused by continuing wearing ill-fitting shoes.
Once a wound forms, it is often slow to heal due to damage of the small blood vessels.
“At the Podiatric clinic, we advise our patients to check their feet daily for cuts, sores, red spots, swelling or infected toenails. If patients are unable to see the bottom of their feet, we advise them to use a mirror to check all around the foot and between their toes, or to have a family member help with the examination. We advise patients to be aware of new foot sores and to monitor any sores daily to avoid longer-term problems. Even small cuts can lead to serious infections and patients might not notice the injury or feel any discomfort from the wound, leaving it to worsen. This makes future treatment much longer and harder for the patient,” Dr Talal explained.
He said nerve damage could also create deformations of the foot that can be painful while explaining that treatment can vary from using special in-soles to support the foot’s form to surgeries that fix the bone structure.
“If a patient loses sensation and suffers from deformations they won’t feel any discomfort and the deformity could lead to abnormal friction between certain parts of the foot, like the top of toes. This friction can lead to ulcers, which if left untreated can become worse,” he pointed out.
Dr Talal recommended annual podiatric check-ups for people with type two diabetes, who have been diagnosed for five years and for people who have type one diabetes and have been diagnosed for 15 years.
People with diabetes need to care for their feet every day to prevent chronic foot injury and are urged to seek immediate care if they injure their feet, he said.
“If patients get injured they should always come for treatment on the same day they spot the injury. Wound healing is slow for diabetic patients and we help them to recover in a suitable way, preventing any possible complications from the injury,” Dr Talal stated.
Diabetics are advised to wear protective shoes that are comfortable and cover the whole foot. Heels and sandals should be avoided as they expose the foot and don’t provide a level platform. The Podiatric clinic can also help patients with special requirements such as the need for protective shoes or shoes that will address certain deformities, he said.
Keeping blood glucose levels within the target range through healthy eating and daily exercise can prevent or decrease nerve damage caused by diabetes.
Diabetic patients are encouraged to exercise regularly in order to open the blood vessels in the legs and prevent nerve damage that can lead to foot complications.
“The most important factor in preventing foot complications for diabetic patients is controlling blood sugar levels. I cannot stress this enough,” Dr Talal added.