One Pair Must Last A Lifetime – The Diabetic Foot (2/2)

People with diabetes suffer from the same problems as those without diabetes, such as pes cavus (a high-arched foot), flat feet, bunions, deformed toes, corns, calluses, blisters, fungal infections etc. The risk is that often the foot is unable to respond to the stresses placed upon it. The body weight transmitted through a local area causes high pressure and leads to callus formation. If neuropathy is present, you won’t know that the callus is pressing on the softer skin underneath and eventually the skin can break down and an ulcer forms. Sometimes a foot with neuropathy becomes swollen and deformed and changes shape permanently, this is a serious condition called Charcot foot

The first signs of neuropathy could be strange sensations such as pins and needles, stabbing or shooting pains, or tingling, As the condition worsens, some people describe "ants or water running down the legs," or "a feeling of walking on cotton wool."

The circulatory changes which affect the feet are caused by hardening (arteriosclerosis) or narrowing (atherosclerosis) of the arteries. These conditions starve the tissues of blood. Occasionally a vessel becomes completely blocked and there is intense pain and the tissues begin to die due to lack of oxygen. Immediate referral to a vascular specialist is required. Other typical symptoms of PVD include pain in the calf of the leg when walking short distances or climbing stairs. Cold feet or legs. Red or blue toes. Loss of hair on the toes. Dry shiny skin on the feet and lower leg.

Unfortunately, far too many people with diabetes and their families are not well informed about the value and importance of footcare. Being informed and aware of the presence of any of the changes mentioned, will enable you to take appropriate action to prevent the serious complications of the diabetic foot.

The current approach to footcare for people with diabetes involves 5 key points:

  • Regular inspection & examination of your feet
  • Find out your risk level
  • Be informed 
  • Use appropriate footwear
  • Have any foot problem treated

To lower your overall risk:

  • See a podiatrist 
  • Don’t use over the counter corn removers
  • Don’t do bathroom surgery
  • Keep your feet clean and dry
  • Check you feet every day
  • Keep your blood sugar level under 8

Footcare for people with diabetes is a team effort. In the case of PVD, early referral to a vascular specialist frequently saves a limb and restores the circulation to a limb or foot. An annual assessment by a podiatrist monitors how diabetes has affected your feet and enables the provision of appropriate treatment of foot problems.



Andrew has taught at the University as well as providing podiatry services in South Africa since 1977. Twice chair of the Podiatry Association of South Africa and a commentator on care of your feet on both radio and television he now works in private practice in Cape Town and Hout Bay.