Diabetic Foot Care
Diabetes Education/ Assessment/ Foot Care
Patients who are diabetic should have a Registered Chiropodist perform routine foot care. The time interval between treatments is dependent on the patient and their risk level. All patients with diabetes will undergo a diabetes screening assessment and appropriate intervals for treatment will be discussed with the patient.
Patients with diabetes are at a higher risk for foot related complications. As diabetes progresses or is uncontrolled, patients may experience a loss of sensation to the feet (Neuropathy). They could be walking on a sharp object in their shoe all day and not feet it which could cause a wound to form on the foot. This, coupled with vascular changes that can occur with diabetes and an increased risk for infection can lead to an infected wound that is very difficult to heal. This is why it is very important for patients with diabetes to do routine foot checks at home and to call the clinic if they are concerned about any abnormality. By seeing a Chiropodist for routine foot care, the Chiropodist will do routine screening, perform the necessary treatments and check vascular and neurological status of the feet. The Chiropodist will also advise on footwear and insoles or orthotics if necessary for the patient to correct any biomechanical abnormality and prevent the formation of ulcerations/wounds.
Wound/ Ulcer Care
Patients with diabetes are more susceptible to developing a wound/ulceration on the foot. As diabetes progresses or is uncontrolled, patients may experience a loss of sensation to the feet (Neuropathy). A patient could be walking on a sharp object and not realize it, or develop a blister due to ill-fitting footwear and not feel it as it is forming. Wounds can also occur on pressure points of the foot. Most commonly, the ball of the foot or the heel. If a patient has a biomechanical problem where there are areas of the foot that take on more pressure than other areas, a callus may form that breaks down into a wound. Since the patient is diabetic, they may not feel the callus forming and therefore do not feel the wound.
Wounds that occur on the feet need proper debriding and dressing changes as well as offloading. Callus will build up over the wound which will need to be removed (debrided). Dressings will keep the wound clean and non-infected. Offloading is one of the most important aspects of wound care. The area being treated, or sometimes the whole foot will need to be offloaded from any pressure until full resolution of the wound. Depending on the severity of the wound and its location will determine the course of treatment for the patient.