Feet and leg care for diabetics

Posted on 17 October 2013

Statistics show that, as a diabetic, if you don’t take care of your feet and legs, and you have a major limb amputation, 50% of patients will have their other limb amputated within two years. Brandon Maggen, a podiatrist working with Mediclinic Milnerton, has this advice.

Why do diabetics need to take care of their feet and legs?
Diabetes is a disease that, if left unattended or untreated, manifests in numerous symptoms that can be debilitating and cruel. One of the most common of these is the set of symptoms that appear and effect the feet and lower limbs. These include a range of nerve and circulation issues, as well as bone and joint pathologies that can dramatically affect your quality of life.

What are the most common ailments to affect a diabetic’s feet and legs?
The ailments seen too regularly in diabetics’ feet and legs include:
•    Vascular insufficiencies, like varicose veins.
•    Swelling of the feet and ankles.
•    Numbness and/or tingling of the toes, feet and legs.
•    Restless leg syndrome.
•    An odd feeling of constriction, or as if you’re walking on sand or eggshells.
•    Skin and nail changes, including fungal infections, cracked heels, callouses, dry skin and leg ulcers (sores).
•    Deformity of the bones and the normal architecture of the foot.
•    Temperature changes of the feet and/or limbs.

It’s universally accepted that, at the time of diagnosis, diabetes has probably been present for about 10 years already! The quicker sugar control is achieved and maintained, the more likely symptoms will cease and improve.

What are the symptoms to watch for with each of the ailments mentioned above?
In general, any changes to the feet and lower legs should be dealt with as suspect until proven otherwise. Patients should literally inspect their feet daily for areas of change. These include: redness, swelling, pain, numbness, tingling, ulceration, heat/cold, deformity, fissures, corns, callous, ingrown nails, fungal infections, etc. It’s vital to note that numbness sets in gradually, with most patients unaware that their feet are numb. So physically looking and feeling (or using a mirror to do so), is pivotal for early detection. Remember to look between all the toes too.

How often should diabetics visit a podiatrist for treatment?
As a rule, twice a year, but if there are any risk factors present, sooner and more often until that risk has abated.

If you ignore feet and leg care as a diabetic, what’s the worst-case scenario?
Diabetes is a cruel disease. If a patient ignores their feet, then gangrene and amputation is imminent. But first is deformity, then ulceration and infection with cellulitis, then loss of sensation and circulation – which means a loss of normal gait, then gangrene, then amputation. At the same time they’re going blind, their kidneys are failing and they have numerous cardio-vascular complications.

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Published in Diabetes

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