Diabetic Foot Disorders

People with diabetes are prone to ulceration of the feet. This is due to multiple effects that diabetes has on the body:

  1. Diabetes damages the peripheral nerves - causing loss of sensation and inability to detect painful stimuli. Diabetes also damages the nerves to the sweat glands of the skin, leading to dry skin which is prone to cracking and ulceration.
  2. Diabetes damages the blood vessels - which reduces the blood supply to the foot, making it more difficult for wounds to heal.
  3. Diabetes interferes with the body's ability to fight infections, increasing the risk and severity of wound infection.
  4. Diabetes causes deformity of the feet for multiple reasons, which can lead to points of high pressure on the foot which in turn can lead to callus, skin breakdown and ulceration.

At least 50% of leg amputations are associated with diabetes, and 85% of leg amputations in diabetics are preceded by a foot ulcer.

Patients with diabetes and ulceration are initially assessed with a history and examination, and may need investigations such as:

  • X-rays
  • Ultrasounds
  • CT Scans
  • MRI Scans
  • Nuclear Medicine Scans
  • Catheter Angiography

Ulceration can be prevented by regular foot care:

  • Daily inspection of the feet
  • Thorough washing and drying of the feet daily
  • Moisturise the feet daily
  • Inspection of shoes daily for foreign objects eg stones
  • Wearing good fitting comfortable enclosed footwear both indoors and outdoors
  • Regular review of the feet by a podiatrist