Diabetic Foot Complications and How You Can Prevent Them

The relationship between Diabetes and foot health

Foot ulcers are the main concern with the diabetic foot. But these wounds do not come about from nothing. There are in fact multiple pathological processes occurring simultaneously. Most of them are caused by the high blood glucose levels that are associated with diabetes.

Peripheral Neuropathy

This can be characterised by a reduction in nerve function, which can manifest in many ways due to the number of different roles the nerves in our body have.

This means you may experience numbness, tingling, muscle weakness, or even like barbed wire around your foot! If you have peripheral neuropathy, a cut or wound on your foot may be unknown to you.

This can have serious health consequences as the wound is prone to infection for a long period of time in the diabetic foot.

A foot is wrapped in barbed wire which is how your feet can feel with Peripheral Neuropathy
A neuropathic ulcer on the bottom of the ball of a foot.

Peripheral Arterial Disease

This is a reduction in blood flow to the feet and legs due to fatty deposits or hardening of artery walls.  If tissue of the feet and legs do not get the required amount of oxygen, it can lead to tissue breakdown. An example of this process is pain in the calf muscle when walking, this is called intermittent claudication.

Chronic Venous Insufficiency

This is a result of the collapsing of valves in the veins returning blood from the feet and legs.

This causes pooling of blood and fluid in the lower parts of the leg and ankles. Common presentations include swelling, and patches of dark discolouration in the lower legs.

Chronic venous insufficiency can lead to skin breakdown called stasis dermatitis.

Foot Deformity

High amounts of glucose in the blood can affect soft tissue at a molecular level in the diabetic foot resulting it tightening and stiffening of soft tissue structures. This leads to reduced range of motion, stiffness and biomechanical abnormalities in multiple joints of the foot.

A foot with HAV deformity and a hammer toe

The biomechanical changes can cause increased plantar-foot pressure in specific areas. For example, Reduced ankle range of motion and stiffness in the forefoot can lead to high pressures under the metatarsal heads, a common area for diabetic foot ulcer.

Queensland Health uses risk classification to determine the likelihood of a person to get a diabetic foot ulcer. A person is considered HIGH RISK if they have two or more of the conditions mentioned above.

There is a high recurrence rate with foot ulcers. To demonstrate this, anyone who has had a foot ulcer in the past, is automatically placed in the high risk category.

Podiatrists are the best equipped health professionals to treat diabetic foot ulcers, and any other foot-related diabetic complications. Podiatrists also use up-to-date technology to assess patients for the conditions mentioned above and to prevent the progression of these conditions.

How we can help you prevent complications

Dynamic Podiatry offers several first class testing methods to help you prevent diabetic foot ulcers and other complications. To help you have healthy, happy feet!

1. Vascular testing

We offer PPG testing which is so sensitive it can pick up the tiny arteries in the ends of your toes.  Using this technology we can measure the systolic pressure in the end of your toe. This gives a great impression of how strong the blood flow in your feet is.  We also perform doppler ultrasound studies to measure the strength and quality of the blood flow in your feet and ankles.

A podiatrist is performing a test of a patient's blood flow

2. Neurological (nerve) testing

We use monofilaments and tuning forks to check how sensitive your feet are to stimuli and check whether or not you have peripheral neuropathy.

A podiatrist is wearing purple gloves and providing nail care for a patient

3. Safe nail cutting and Callous removal

When you have diabetes it is crucial that your nails are cut safely to prevent wounds developing. We have the skills and equipment to ensure your nails are cut safely. ​ Callouses and corns can build up and develop into ulcers; especially if you have peripheral neuropathy. We have the skills and equipment to safely remove callouses and corns and to treat any ulcers that have developed.

We also have direct access to Queensland Health if you need to be referred to them for regular ulcer care.​

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