There is an increased risk of foot problems and lower limb complications when a patient suffers from diabetes. These complications can be subdivided into
- Microvascular disease (retinopathy and nephropathy),
- Nervous system abnormalities and macrovascular disease (coronary, peripheral vascular disease and cerebral vascular disease).
Common conditions associated with diabetes are neuropathy (loss of feeling in the foot), peripheral arterial disorders (loss of blood flow) and a decreased immune response. All of these expose diabetic patients to potentially serious foot problems. It is because of the increased risk that.
Diabetic Peripheral Neuropathy
Often, patients first complain of an altered sensation in their feet. This can feel like tingling, burning, numbness or pins-and-needles. As the neuropathy progresses, patients eventually lose all feeling in their feet. Protective sensation may become completely lost. When a patient has lost their protective sensation it becomes a great concern. They loose the ability to feel bath water that is too hot, a rock in their shoe, open wounds, sores, cuts or blisters.
Foot shape can also change in a diabetic due to the loss of sensation and vascular compromise.
Vascular Compromise
Blood circulation problems are more common in diabetics. Commonly, the cause of these problems are from the high levels of glucose circulating in the blood. Circulation can be sub-divided into the arterial system and venous system Diabetes can affect both of these systems. Arterial manifestations can result in a lack of blood flow to the foot, resulting in poor tissue health and delayed healing. Venous manifestations can cause lower leg swelling, leading to many dermatological conditions such as ulceration and deep vein thrombosis.
Immunological Compromise
Healing from infections is much harder for diabetics because of the increased glucose levels in the blood supply. It causes the immune system to become sluggish and an issue like a diabetic ulcer may take months or years to heal.
Anyone who suffers from diabetes should have regular foot appointments
