Diabetic Foot Care

The feeling in the feet (peripheral neuropathy)

The peripheral nervous system is the nerves outside the central nervous system (the brain and spinal cord). There are three main types of nerves within the peripheral nervous system:

• Sensory nerves – provide sensations, such as pain and touch
• Motor nerves –controlling muscles
• Autonomic nerves –regulates automatic functions of the body, such as blood pressure and sweat production

Signs of peripheral neuropathy

• Tingling and numbness
• Burning, stabbing or shooting pain in affected areas
• Loss of balance and co-ordination
• Muscle weakness

Complications of peripheral neuropathy

This depends on the underlying cause and which nerves are affected.

Some cases may improve with time if the cause is addressed, whereas for some people the damage may be everlasting.

If the cause isn't treated, you may be at risk of potentially serious complications, for instance foot ulceration may become infected.

The circulation in your Feet (Peripheral arterial disease)

Signs of peripheral arterial disease (PAD)

• A lot of people with PAD have no symptoms.
• Intermittent claudication: a painful ache in the legs when walking, this usually resolves after a rest.
• Weakness in the legs

• Brittle and slow-growing toenails 
• Ulcers of the feet or leg
• Skin color becoming pale or blue

PAD can lead to Critical limb ischaemia (CLI)

The blood flow to the legs becomes significantly restricted, which can be a serious complication, that can be difficult to treat.

Symptoms of CLI include:

• Burning pain in the legs and feet that continues with rest.
• Toes or lower limbs becoming cold and numb, developing red and then black

What is looked at it an assessment

The changes to the feet can happen slowly over time, and you may not detect an changes. At heal and soul podiatry, we recommend people with any form of Diabetes, have their feet assessed on an annual basis or more regularly if advised. This is in-line with the Victorian state guidelines.

• Looking at current medical history, medication and ability to self-care.
• Neurological supply to the feet: we asses all three parts of the nervous system supplying your feet to note any alteration.
• Vascular supply to and from the feet:  listening to the arterial supply as well as taking a blood pressure reading in the leg and arm, to give an overall impression.
• The structure of your feet and visual gait analysis: this will aid in detecting high pressure areas which are at greater risk of ulceration.
• Ulceration and foot lesion history.
• Footwear assessment.
• Any other concerns you have

Once the assessment is carried out a risk category is allocated. The Podiatrist will then discuss with you, management strategies to help you to maintain good foot health, and reduce the risk of further complications.

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