Diabetes and feet

There are different types of foot disease caused by diabetes, but they all stem from a similar process. Raised blood glucose levels for a prolonged amount of time causes damage to blood vessels. This can lead to damage of 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.

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. The video below discusses what you can do to look after your feet.

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 which 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.

The frequency of further screening and the need for an onward referral or podiatry care is determined by the risk score.

No signs of neuropathy or poor blood supply. You will be advised to keep up your foot care and continue to attend yearly foot checks. You are at low risk of developing further foot complications. 

A slightly higher risk of developing foot complications and you may have absent pulses in your feet or have developed some form of sensory loss. You may need treatment from a podiatrist and you will be encouraged to keep up your regular foot care and yearly check-ups.

People that may currently have or have suffered from ulcers and foot trauma in the past will fall into this category. You will require regular treatment from a podiatrist and could be at risk of requiring amputation in the future. You should regularly care for your feet and follow the guidance from your podiatrist. 

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