Podiatry for people with diabetes

Diabetes and foot health:
It all comes down to care

Diabetes mellitus, particularly type 2, is widespread in developed countries. Elevated blood sugar levels do not always cause acute symptoms in those affected. However, over time they can damage blood vessels and nerve cells, thereby impairing important bodily functions – including those in the feet. Increased vigilance in daily life and professional podiatry are essential so that your diabetic patients remain well mobile for as long as possible.

Diabetic foot develops gradually

Yet in the early stages of diabetes, there is an increased risk of developing certain complications. Diabetic polyneuropathy is especially common. Among other things, this condition compromises the skin’s natural balance, as the affected nervous system also regulates the production of protective sebum and sweat. The skin on the feet becomes dry, possibly cracked, and is therefore more susceptible to injury. Even more serious are diabetes-related vascular complications: they impair blood circulation in the feet and so that the supply of oxygen and nutrients is impaired. Wounds heal slowly or not at all, and bacteria can spread. And this often happens without the patient even noticing.

Disturbed pain perception often means dangers go unnoticed

Especially attention should be paid to the fact that diabetes-related nerve damage also reduces pain sensation in the feet. Minor injuries, pressure points or a stone in the shoe often go unnoticed. The foot is neither treated nor relieved; minor wounds can quickly worsen, become chronic and, in the worst case, damage the tissue so severely that an amputation becomes necessary. This makes it all the more important for patients to carefully examine their feet every day so that even the smallest injuries can be discovered and treated.

Impaired pain perception often means dangers go unnoticed

Especially attention should be paid to the fact that diabetes-related nerve damage also reduces pain perception in the feet. Minor injuries, pressure points or a stone in the shoe often go unnoticed. The foot is neither treated nor relieved of stress; minor wounds can quickly worsen, become chronic and, in the worst case, damage the tissue so severely that an amputation becomes necessary. This makes it all the more important for patients to carefully examine their feet every day so that even the smallest injuries can be discovered and treated .

Help your patients to discover the early signs

People with diabetes should not only check their feet themselves every day, but also have them examined by a doctor on a regular basis. The better people with diabetes understand the signs that indicate the onset of diabetic foot syndrome, the better the chances of successful treatment. Check the sensitivity in your patients’ feet and legs (e.g. using the RUCK monofilament) and encourage them to examine their feet themselves regularly (particularly the heels, soles, toes and spaces between the toes) using a hand mirror or diabetic mirror.
Explain the possible symptoms in simple terms: Is the foot cool and is the skin noticeably pale and dry? Are there blisters, pressure sores, inflammation, skin cracks, thickened or callused areas of skin, or different changes? Are the nails and skin of the feet prone to fungal infections? Invisible signs of a diabetic foot that is proceeding can include insensitivity to pain, pressure and temperature, along with numbness and tingling.

Proper podiatry at home

Those affected can take certain steps themselves to prevent changes to their feet. Washing the feet regularly in a lukewarm foot bath is essential for people with diabetes. Afterwards, the feet must be dried correctly, including the spaces between the toes. If patients maintain their toenails themselves, they must then use a nail file. With you, the nails should always be filed straight across, not rounded.

Scissors, clippers or nippers should not be used due to the increased risk of injury. Calluses should be treated using a gentle pumice stone. After care, diabetic feet – which are usually dry – must be generously moisturised. Products containing urea (5–10% urea), tea tree oil or microsilver are suitable for this purpose.

Important: Small wounds on the feet should not be washed, but only disinfected. You should therefore advise your patients with diabetes to always have a wound disinfectant spray to hand.

Frequently asked questions and answers

Why is foot care particularly important for people with diabetes?