After a meal, a portion of the food a person eats is broken down into sugar (glucose).
The sugar then passes into the bloodstream and to the body’s cells via a hormone (called insulin) that is produced by the pancreas.
Normally, the pancreas produces the right amount of insulin to accommodate the quantity of sugar. However, if the person has diabetes, either the pancreas produces little or no insulin or the cells do not respond normally to the insulin. Sugar builds up in the blood, overflows into the urine and then passes from the body unused.
Over time, high blood sugar levels can damage:
- Eyes – leading to diabetic retinopathy and possible blindness;
- Blood vessels – increasing risk of heart attack and stroke;
- Nerves – leading to peripheral neuropathy, foot sores and possible amputation, possible paralysis of the stomach, chronic diarrhoea;
- Kidneys – leading to kidney failure.
It is important to note that controlling blood pressure and blood glucose levels, plus regular screenings and check-ups, can help reduce risks of these complications.
As a Podiatrist, I will concentrate on the prevention and management of foot complications occurring in the diabetic patient. It is very important to maintain good consistent blood glucose levels with an HBA1C of 6.4mmol. All diagnosed diabetics should see a podiatrist annually. However the frequency of visits is determined by the podiatrist depending on the level of complications and pathologies (diseases) that are present.
Patients should examine their feet daily as they may be injured and unable to feel that they are injured due to having sensory neuropathy. Sensory neuropathy in diabetics is the major cause of ulceration and amputation of the toes, feet and lower limbs. Loss of feeling is a particular risk because it can allow foot injuries to escape notice and treatment, leading to major infections and amputation.
Smoking is another contributing factor to lower limb disease and reduction in healing of diabetic foot wounds and ulcers. Diabetics must stop smoking.
Untreated calluses and corns on the feet of a diabetic patient can lead to haemorrhaging under the callus which results in ulceration and possible non- healing, leading to infection and resultant amputation.
A podiatrist is the only qualified professional to treat calluses and corns. Patients are to be very careful about seeing other pedicurists who are not podiatrists, as this could increase the risk of wounding and resultant amputations.
Footwear is another important factor to consider. Your podiatrist is always willing to advise patients regarding this matter.
Diabetic feet usually do not sweat and are very dry; a proper foot cream should be used to maintain the elasticity and integrity of the skin.
Please look after your bodies, control blood sugars, and do what is possible to prevent the complications before they start. This way one can live a long healthy life with diabetes.
My motto is PREVENTION IS the CURE.
Lets all work together.
Andy Blecher – Podiatrist
2 Burnham Road, Plumstead, Cape Town
Tel: 021 797-6967