Diabetic feet

What is a diabetic foot?

The term “Diabetic foot” describes changes that occur in the feet of people with diabetes. Diabetes can damage important tissues in the foot including the skin, nerves and arteries. This damage can lead to reduced sensation, change in the shape of the foot and reduction in blood flow predisposing patients to develop ulcers and infections, which if untreated may lead to amputation. Diabetes is the most common cause of leg amputation in Australia.

People with diabetes have a high risk of developing foot problems.

What are the symptoms of diabetic foot problems?

  • Dry scaly skin
  • Loss of sensation
  • Painful or cold feet
  • Cracks in the skin
  • Calluses
  • Changes in the shape of the foot
  • Ulcers
  • Gangrene

What causes diabetic foot problems?

  • Neuropathy

Damage to nerves (neuropathy) leads to loss of sensation in the foot, wasting of important muscles in the foot leading to structural changes and loss of sweat production leading to drying and cracking of the skin.

  • Structural abnormalities:

Changes in the shape of the foot due to damage to motor nerves (nerves that supply muscles of the legs and foot), muscles, tendons and joints leads to areas of high pressure that may lead to callus formation and ulceration.

  • Skin changes:

Damage to nerves that control the glands in the skin of the foot that produce oil and moisture leads to drying, peeling and cracking of the skin.

  • Poor circulation:

Diabetes damages the arteries that bring blood into the leg and foot. The arteries harden and narrow, limiting the blood flow into the foot, which may cause pain with walking, pain at night, ulceration or in severe cases gangrene.

What are the risk factors for diabetic foot problems?

  • Poorly controlled diabetes
  • Longstanding diabetes
  • Chronic Renal failure
  • Smoking
  • Blindness or visual loss
  • Poor circulation
  • Older age

How will my diabetic foot problem be assessed?

  • History and examination
  • Testing for neuropathy – monofilament and vibration testing
  • Arterial Duplex ultrasound
  • Arterial pressure measurements
  • CT angiogram
  • Catheter angiogram
  • Foot x-ray
  • MRI scan
  • Bone scan
  • Wounds swabs

What treatments are available for diabetic foot problems?

  • Footwear
  • Antibiotics
  • Medications
  • Wound dressings
  • Surgery to correct deformities
  • Balloon angioplasty or stenting of arteries
  • Arterial Bypass surgery
  • Skin grafting