Diabetes is a disease that can contribute to the ‘furring’ of leg arteries and therefore the diabetic foot can be vulnerable to poor circulation.
Other factors contributing to the ‘furring’ of arteries would include diet, genetic predisposition, lack of regular exercise, obesity, and perhaps the most significant…smoking.
Many issues involving the adverse effects of diabetes can be minimised if patients manage their condition diligently and lead a healthy lifestyle. If you are a Diabetic it is absolutely essential that you do not smoke. Diabetics who smoke would eventually be likely to experience devastating vascular effects.
If a foot is deprived of an adequate supply of blood the skin quality will deteriorate. The skin will become thinner, drier, and its ability to withstand stress and trauma will therefore become reduced. Consequently the skin will become more vulnerable to damage, ulceration/necrosis, and infection. Also healing times of wounds will become longer.
In addition to possible issues of poor circulation some Diabetics may experience reduced sensitivity in their feet (Peripheral Neuropathy).
Pain is an important protective mechanism in as much as it draws attention to a damaged area thus prompting the patient to act.
If the ability to sense pain is diminished then problems can become unnoticed for some time thus increasing the possibility of further damage, ulceration/necrosis, and infection.
It is recommended by Diabetic Specialists for patients with diabetes to be tested annually for signs of poor peripheral circulation and loss of sensation; both of these complications often affect the feet without the patient being aware. Consequently we undertake annual Vascular & Sensory testing for our diabetic patients.
At this practice the tests for Peripheral Vascular Disease include Ankle Brachial Index (and Toe Brachial Index if indicated) readings using Photoplethysmography (PPG), and Doppler. Sensory testing would include light touch and vibration, the vibration test is undertaken using a neurothesiometer machine rather than a tuning fork.
General advice for Diabetics
To significantly reduce the chances of developing any foot pathologies that could arise as a consequence of diabetes, the following advice will serve you well.
- Attend Diabetic Clinics with your GP/Diabetic Nurse regularly.
- Be diligent in monitoring your blood sugar levels and taking of insulin/tablets.
- Exercise regularly, eat healthily, DO NOT SMOKE.
- Undertake annual Vascular & Sensory testing with your Podiatrist/Chiropodist.
- If you are unable to maintain your own foot health, or develop symptomatic problems then visit your Podiatrist/Chiropodist regularly.