In Australia, diabetes is the most common cause of non-traumatic amputation, with some 2,800 attributable annually. While diabetic-related foot disease is complex, when risk factors are identified early, and with appropriate management implemented, the risk of lower-limb amputation drops significantly. Amputation is preventable — and recent research has shown foot-health improvements in diabetics who regularly see a podiatrist for care.

People with diabetes have poorer defence against infection. Minor cuts and abrasions to the foot can turn into infection.

Decreased blood flow or blocked blood vessels is common and more severe in people with diabetes. It can lead to poor healing due to the lack of blood supply, ulceration, claudication (pain in the calf upon walking) and rest pain.

Nerve damage may lead to sensations such as ‘pins and needles’, numbness, tingling, burning, pain and cold feet. As a result, a lot of pressure can be exerted at one spot under the foot when walking, resulting in callous build up without causing discomfort. The pressure becomes so high that eventually it causes breakdown of tissues and ulceration with no pain.

These may start as a red spot caused by pressure from footwear and the inability to feel the area. Blisters, callous and sores that go unnoticed for a period of time have the potential to develop into ulcers. It is essential that daily foot checks are utilised to minimise harm to the skin.

Ulcers and sores result from a combination of factors: a change in mechanics, altered nerve supply and decreased blood flow. When a sore becomes an ulcer there is a breakdown of several layers of skin which become infected. Ulcers require a long period of time to heal.

The foot may change in structure when the bones in the foot become weakened and fractured without major trauma. This can result in changes of pressure distribution which may lead to ulceration.

All of these issues can be managed successfully providing good foot health is maintained.

Our podiatrists carry out a foot assessment for diabetics by determining risk and treatment levels, ensuring no unnoticed problems exist.