We see our fair share of diabetic patients at the clinic most weeks. Sometimes the patients we see are not so sure about just how diabetes affects their feet or just how important it is to have regular foot checks.
So we've put together a few points that everyone should know about diabetes, in plain english so that everyone reading it can understand.
The first thing to note is that diabetes is generally split into two groups called type 1 and type 2 diabetes. Treatment guidelines have changed of late and many people who would have been considered type 2 diabetic now use insulin as part of their treatment plan.
Diabetes is a condition resulting from either, the absence of insulin in the body to help break down and use glucose from the blood, or having some insulin but having too little or poor quality.
Diabetes can have serious implications for your feet and legs. If you have poorly controlled blood glucose particularly over a long period of time changes can happen to the nerve and blood vessel tissues in your lower limbs. So what! you might say.
Well, if the nerve tissue changes and becomes less conductive, this is called peripheral neuropathy. Having peripheral neuropathy increases the risk of injury. Because the feeling can be absent in the foot injuries are common, although often the sufferer is unaware of injury to the foot. The result of this can lead to breakdown of the tissue, or as we call it, ulceration.
Ulceration is complicated because of the hardening of the arteries which is also caused by prolonged poor glucose control. Sufferers will lack the ability to supply damaged tissue with a sufficient blood supply. This prolongs healing, increasing the risk of infection and ultimately leads to gangrene and amputation.
Now heres the scary part...statistically, the mortality rate (chances of death related to the disease) is greatly increased if an amputation has been required. What we find is that, in general, because diabetes is a 'silent' disease', often without any outward signs, people either dismiss it, deny it, or just don't understand enough about it. It is that serious. Diabetes, if poorly controlled or neglected for periods of time can seriously impact on your foot health and ultimately lead to your premature departure.
Finally, the best way that you can prevent these changes happening for as long as possible is to maintain good blood glucose levels. What we mean by that is your average blood sugar levels. Daily readings will fluctuate, this is normal even in a person who doesn't have diabetes. The average blood sugar is measured by HbA1c. Because the recommended level can change sometimes there's little point in writing it down here, but we would encourage all patients we come across in the clinic to discuss their blood glucose levels with the GP. Ask the GP for your HbA1c levels, learn about getting it to the best levels you can, and finally, own your disease, take control of it, don't allow diabetes to control you, or to destroy your quality of life.
If you have diabetes and are worried about your feet, or if you have any other questions about your feet please contact the clinic to arrange your assessment today. We will be happy to advise you and to carry out your diabetic foot check.
For more information about diabetes visit http://www.diabetes.org.uk/
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