What is diabetic foot?

Diabetes can affect the feet in a number of ways and diabetic foot is said to occur when the foot displays symptoms of a condition arising from diabetes or complications of diabetes. This can include a range of problems, such as ulcers and infections.

What are the symptoms?

Leg ulcers, infection and sores are common complications. In severe cases, sepsis can lead to amputation of the foot. Problems like athlete’s foot, calluses, fungal nail infection, corns, blisters, bunions, dry skin and ingrown toenails can pose a more serious problem for those with diabetes.

Blisters and other foot injuries will typically heal slowly and breaks in the skin or discharge from a wound, changes to the colouration of the skin, swelling around an injury and/or an ulcer all need immediate attention for those with diabetes.

What causes or what produces diabetic foot?

Damage to nerves and blood vessels from high blood sugar over time can cause loss of feeling (neuropathy) in the feet and can impair the body's healing ability due to reduced blood flow. As a result, damage to the foot may go unnoticed and take longer to heal, leading to ulcers and infections.

How can diabetic foot be prevented?

For diabetics, it is firstly very important to try and keep blood sugar levels under control to prevent damage to the nerves and blood vessels. As normal foot problems are more problematic, it is recommended that:

• feet are checked regularly
• toe nails are trimmed regularly
• shoes and socks are worn to protect the feet
• good circulation is maintained
• feet are washed regularly.

In addition, people at high risk of getting ulcers may undergo screening. Good patient education can also help prevent problems. It is also recommended that the patient stops smoking as this also worsens circulation. Therapeutic shoes can also help to protect the feet.

What is the treatment of diabetic foot?

The specific treatment will depend on individual circumstances and the type of foot problem being dealt with.

Where diabetic foot ulcers are present, it is important to avoid making the ulcer worse and to prevent it from becoming infected. Taking pressure off the feet as much as possible helps to prevent the ulcer worsening and allows time for it to heal. Diabetic shoes, shoe inserts, compression wraps etc. can also be used.

If the ulcer is infected, it will need to be treated straight away. The treatment will depend on the type and severity of the infection and can include medication like antibiotics or topical treatments.

In more severe cases, surgical treatment may be necessary. This can include the removal of foot deformities or even amputation in the case of life threatening infections.

What specialists treat diabetic foot?

Diabetic foot often requires a multidisciplinary team approach to treatment, depending on the severity of the case. Therefore, diabetic foot may be treated by a general physician, endocrinologist, vascular surgeon, a specialist in internal medicine, surgeon and physical therapist.