Understanding diabetes complications of the lower limb
Foot complications in diabetes are common but they could post a lifetime disability if no proper foot care is taken. A simple foot ulcer might seem ignorant and non-critical; however, failure of foot ulcers healing can lead to amputation. Of those who have an amputation, about half will experience a subsequent amputation of the other limb. Five-year survival for those who have had limb amputation is poor. Diabetes can affect the feet in a number of ways, mainly the circulation and nerve supply.
Reduced blood supply to the legs and feet may result in delayed healing. Symptoms include night cramps or extreme pain in your legs with walking, skin discolouration, or cold feet. Smoking increases the risk of vascular complications of the lower limb.
Nerve damage may result in the loss of sensation in the feet. This can leave you prone to injury to your feet without you being aware. Some symptoms you may experience include numbness, burning, tingling or pins and needles.
Diabetes may cause the skin on your feet to become dry. Moisturise regularly with products such as sorbolene, or urea-based product available from the podiatry clinic or chemist to reduce the problem. If dryness continues, speak with your podiatrist.
Most foot problems can be prevented
Evidence suggests that the following are the keys to reducing diabetic complications that affect the feet.
Good control of blood sugar levels
Regular exercise and a low-fat diet will help keep your blood sugar, heart, and circulation healthy which in turns will be good for your feet
Daily inspection and regular foot care. By inspecting your feet daily, any problems can be detected early. Wash and dry your feet daily, paying special attention between the toes
Check for any redness, swelling or sore spots. A mirror may help if you can’t see under your foot
Cut and file nails carefully using a pair of nail clippers, not scissors. Do not cut the nails too short, or cut down the sides of the nail
Seek professional advice when necessary. Podiatrists can treat and often prevent corns and callous. If you have problems with infections, then it is important to have these attended to before they become problematic
Some foot problems occur due to poor fitting or inappropriate shoes. Footwear that rubs or irritates your feet may cause harm especially if the sensation is poor. When choosing shoes, ensure they have:
a leather or a breathable upper to allow air to circulate
room in the toe-box to move your toes freely
at least 1 cm between the end of your longest toe and the end of the shoe
always have your feet measured
either a strap or lace up
a firm heel counter
are right for the activity, eg/ walking shoes or runner for exercising
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