Updated: Aug 5, 2019
This week is Diabetes Awareness week. As many of you know, my family and I are particularly passionate about educating people about Diabetes as our eldest son was diagnosed with Type 1D 4 years ago.
We are offering FREE diabetic foot check ups this week. Please call 9817 3763 or click HERE to book online. Please select FREE DIABETES FOOT CHECK.
Please note - no treatment will be offered at this appointment.
In our clinic we see a large number of clients every week who have Type 2 diabetes.
Why is that?
Because Diabetes affects the feet. And often.
When some one is first diagnosed with Diabetes they are often referred to a Diabetes Educator who will explain the condition, treatment options and complications. There is a huge amount of information to take in and what we find is that people often don't absorb it all. The aim of this blog is to help people understand the importance of good diabetes control and good foot health.
Why does Diabetes affect your feet?
There are 3 main mechanisms that can cause issues with foot health.
1. Decreased blood flow
2. Decreased sensation
3. Fragile skin
Don't think for a moment that one high blood sugar reading will cause these issues. But we all should be aiming for good control. We'll talk more about what that means later. But when we are talking about foot complications, we use the saying ' you can't feel and you can't heal'. That sums diabetic foot complications up perfectly. So this means, that say you got a small stone in your shoe, if the feeling in your feet is impaired you may not feel it. It rubs and causes a cut or wound. Because your blood flow is reduced, your immune system struggles to fight off any infections and your body can't heal easily. And that's how ulcers develop. Ulcers, when left untreated or in very compromised people can lead to amputations. The other reason people develop foot issues is because they have diabetes related vision problems called retinopathy. It makes caring for your feet safely very difficult if you can't see properly. Don't risk accidently cutting your skin or giving yourself and ingrown nail. We will happily cut your nails for you.
Why see a Podiatrist?
It is recommended that every person with Diabetes has an annual foot check up. All of our clients have this as part of their normal treatments.
But did you know that only 20% of people take the time to have this check up? To me that is horrifying.
What if an assessment with a podiatrist identified issues BEFORE they became big problems? Wouldn't that be worth it? In a diabetes assessment a podiatrist should:
1. Use a 'Doppler' to test your blood flow. Feeling the pulse with a finger is not accurate and does not give you the whole picture. Ask for a Doppler assessment
2. Assess the temperature and colour of your skin
3. Assess the sensation (feeling) to your feet using a Tuning fork and a Monofilament. These 2 tests measure 2 different types of sensation
4. Assess the health of your skin and nails, looking for corns, callous, warts and infections
5. Assess your foot joints looking for areas of increase pressure where ulcers could develop
6. Assess your footwear for signs of wearing and also to see if they fit. It is incredibly common for people to be walking around in ill-fitting shoes that put pressure on toes, bunions and heels.
7. Provide you with an overall risk assessment
8. Write to your GP to keep them informed.
Even if you do not have any current issues, having an assessment gives us a good baseline. So if changes do occur, we know over what period of time. The other benefit of seeing a podiatrist regularly is to have tricky or thick nails cut, thus preventing ingrown toenails, as well as to remove callous and corns. Your feet will be much more comfortable which allows you to keep moving.
What are the symptoms of Diabetes related foot issues? Things to look out for and report immediately if you notice.
1. Changes in sensation
- cramps, especially when walking
- pain with light touch (like the bed sheets)
2. Changes in temperature
- very hot feet
- very cold feet
3. Cuts not healing as fast as normal
4. Very dry skin on the feet due to decrease sweating
5. Infections, including of the skin or nails
7. Pain or changes in the shape of your feet
What is good blood sugar control?
It is recommended that blood sugars are between 4-6mmol/L. And that the 3 monthly check up reading is under 7%. Good blood sugar control comes from following a healthy diet and taking part in regular exercise, as well as following the medication advice of your GP or Endocrinologist. There is increasing evidence to suggest that a lower-carbohydrate diet is the way to go for all people with diabetes. Simply put, carbohydrates are glucose molecules in a chain. And what should people with Diabetes avoid? Sugar..... If you'd like more information on this please visit www.lowcarbdownunder.com.com
What can I do at home to help my feet stay healthy?
We have created a free downloadable guide that you can access here
Lastly, can I just say that there is no reason to be embarrassed by your feet. We often find this is the main reason people delay assessment or treatment. We have seen it all. Seriously. Nothing shocks or surprises us. If you are still not convinced, Medicare is so keen on all patients with diabetes having affordable access to podiatry care that they will subsidise up to 5 visits a year with a podiatrist. You need a doctors referral to access this plan which is called an Enhanced Primary Care (EPC) plan. If you have an eligible referral from your GP, your maximum out of pocket cost per appointment is just $29.20
Don't become a statistic......
Diabetes by Number
- 1.7 million people in Australia have Diabetes. That's 12% of our population
- 1 in 4 adults over the age of 25 is either diabetic or pre-diabetic
- 10,000 people are admitted to hospital each year due to diabetes related foot ulceration
- one person develops Diabetes every 5 minutes
- the cost to the health system is estimated at $14.6 billion
- there are more than 4400 amputations each year
- in 2005, 1000 Australian's died from Diabetes related complications
- Diabetic foot disease costs our country $875 million each year
- 25% of people with diabetes have vision issues
- Blood sugar readings should be between 4-6mmol/L
- HbA1c ( 3 month average reading) should be less than 7%
- Type 1 Diabetes accounts for 15% of all cases and effects mainly children
- Only 20% of Australians with diabetes get regular foot checks
Below, Eliza talks about the symptoms of undiagnosed diabetes to watch out for