According to the Canadian Diabetes Association, there are more than 9 million Canadians living with diabetes or pre-diabetes. There were 4,400 diabetes-related amputations in 2008.

Diabetes is a chronic, often incapacitating and sometimes deadly disease, in which the body either cannot produce insulin or cannot properly use the insulin it produces. This leads to high levels of glucose in the blood, which can damage organs, blood vessels, and nerves. Nervous system damage (also called neuropathy) affects about 60 to 70 percent of people with diabetes and is a major problem that may cause diabetics to lose feeling in their feet or hands.

With a diabetic foot, a wound as small as a blister caused from wearing a shoe that’s too constricted can cause a lot of damage. Diabetes decreases blood flow, so injuries are slow to heal. Also, diabetics often have reduced sensation, especially to their feet, so an injury may go undetected. When your wound is not healing, it’s at risk for infection. As a diabetic, your infections spread quickly. If you have diabetes, you should inspect your feet every day. Look for puncture wounds, bruises, pressure areas, redness, warmth, blisters, ulcers, scratches, cuts, and nail problems. Get someone to help you, or use a mirror.

Areas of high pressure are especially susceptible to develop corns and calluses that may become wounds and come infected. Diabetic and Advanced Foot care Nurses are highly skilled in reducing calluses and corns, in order to prevent wounds from occurring. It is also advisable for diabetics to wear proper footwear and custom foot orthotics, in order to reduce areas of high pressure.

Diabetic foot concerns:

• Neuropathy or lack of sensation in the feet
• Poor circulation or lack of blood flow to the feet
• Burning or tingling in the feet
• Dry skin
• Areas of high pressure can ulcerate
• Corns, callous and cracked heels
• Hammer toes, Claw toes and mallet toes
• Wounds that do not heal
• Amputation

Diabetic foot care advice:

• Keep your blood sugar between 5 and 7
• Check your feet daily
• Always wear footwear that fits properly
• Keep feet dry and clean
• Apply foot lotion to feet
• Wear white socks so you can see if you injure your foot
• Check your shoes for debris prior to putting them on every morning
• Wear a variety of different proper fitting shoes
• Wear cotton socks with no seams or elastics
• Walk and keep active
• If you have a concern, contact our office immediately

If left untreated:

• Small issues become big problems quickly in diabetic feet
• Wounds or ulcerations may not heal
• Wounds then become infected
• Wounds can become gangrenous
• According to the Canadian Associate of Wound Care,
  • 85% of all amputations are due to non-healing foot ulcers
  • More than half of these amputations may have been prevented with proper footwear and foot care
  • 1500 Ontarians had a limb amputated in 2008

Treatment:

• Diabetic foot assessment
• Sensation testing
• Skin assessment
• Nail care including thick, fungal, and ingrown nails
• Corn and callus reduction and offloading
• Wound care
• Refer clients for orthopedic shoe fitting
• Refer clients for custom foot orthotics