Diabetes and your feet
Diabetes affects a growing number of the population and can have huge implications on the feet.
Many changes can happen to a diabetic such as:
- Anhidrotic (dry skin)
- Hard skin
- Neuropathy (lack of sensation)
- Changes to the shape of the foot (extensor substitution)
Anhidrotic skin is more like to crack or split than normal skin is which increases the risk of infection. To help reduce this risk, feet should be moisturised on a daily basis.
Hard skin is formed by pressure and usually before ulceration. Hard skin should be removed by a podiatrist on a regular basis. The patient should continue to moisturise daily.
Neuropathy is a huge risk for those with diabetes as they would not be unaware of standing on sharp objects and not dressing any cuts or breaks of the skin. Those who have a lack of sensation should ensure their feet are always protected with footwear. Feet should be inspected regularly for breaks in the skin and medical advice should be sought as soon as possible if any are found.
Changes to the shape of the foot can happen, with the retraction of the lesser toes. This causes areas of higher pressure at the base of the toes (plantar to the metatarsal phalangeal joints). Furthermore, the natural fatty pad under these joints moves forward as the toes retract. This increases the pressure under these joints. The extra pressure here enhances the risk of ulceration especially if the individual has neuropathy.
Complications in the diabetic foot can be reduced by wearing appropriate footwear, vigilance, the daily application of moisturiser and most importantly, visiting a podiatrist for debridement of hard skin.