Diabetes and feet

Foot complications are rare if you keep glucose levels controlled. Raised blood glucose levels for a prolonged amount of time causes damage to blood vessels. This can lead to damage to the nerves that supply sensation and the blood circulation of the leg. 

The damage to the nerves is called peripheral neuropathy. This causes a loss of sensation and pain in the feet and lower legs. The loss of feeling can lead to damage and trauma to the foot. The damage to the blood vessels causes narrowing which leads to reduced blood and oxygen supply to the legs.

Both neuropathy and vascular problems can lead to a higher risk of foot injuries such as ulcers which, due to the poor circulation may not heal well. This video below explains this process.

Adequate foot care is essential in diabetes to reduce the risk of these complications. This involves keeping nails trimmed and filed, washing and drying feet regularly, and keeping them moisturised. Footwear must be checked regularly for any damage or change too. 

In the video below you can hear some people with diabetes talking about their foot complications and health care professionals discussing how to avoid them.

Foot Screening 

Foot screening is a recommended part of routine care for people with diabetes. It is important that people with diabetes check their feet for any potential problems every day. 

Foot screening is used to pick up any early signs of neuropathy (foot nerve damage), peripheral vascular disease (resulting in reduced blood flow to the feet), or other abnormalities that may put the individual at increased risk of ulceration or amputation. You should receive foot screening at least once a year from your healthcare team. 

Low-risk:  No signs of neuropathy or poor blood supply and people with diabetes are recommended to keep up their foot care and continue to attend yearly foot checks. They are at low risk of developing further foot complications. 

Moderate risk : A slightly higher risk of developing foot complications and people may have absent pulses in their feet or have developed some form of sensory loss. These people may need treatment from a podiatrist and are encouraged to keep up with their foot care and yearly check-ups. 

High-risk: People that may currently have or have suffered from ulcers and foot trauma in the past. These people require regular treatment from a podiatrist and could be at risk of requiring amputation in the future. They should regularly care for their feet, following guidance from their podiatrist. 

You should be aware of the risk score you have been assigned by your healthcare professional.