Diabetes, Sugar- whatever you call it, is one of the most common chronic non- communicable diseases in Jamaica. This is a disease that once a person has it, they will always have it and it is not passed from person to person.
Diabetes is a syndrome of derangement in the chemical processes needed to maintain life (metabolism) and inappropriate high blood sugar levels (hyperglycaemia). This is due to either relative/ absolute insulin deficiency or a reduction in the effectiveness of insulin, you may have both of these processes working together to cause diabetes.
Insulin is a hormone produced by the body and is important in how the body uses glucose, fatty acids and amino acids.
In 2017, the prevalence of diabetes in adult Jamaicans was reported by the International Diabetes Federation to be 11.4% with 209,300 persons living with the disease. Many of us either know someone with Diabetes or have it personally.
Diabetes can affect the eyes, heart, blood vessels, nerves and kidneys but today we will talk about foot care.
Since diabetes damages the nerves, vessels and the immune system this can make feet more prone to being affected. When nerves are affected they interrupt a persons ability to feel, so they are more likely to stand in one position too long, which can cause a pressure ulcer, or they might not feel when they stand on something sharp or get a cut. The blood vessels are what carry blood and oxygen around the body, a good blood supply is needed to help with healing of cuts. So when these are damaged it prevents how well a cut can heal for a diabetic. When the immune system is involved it reduces the persons ability to fight off infections, so cuts are more likely to get infected.
Some effects of uncontrolled diabetes specific to the feet are:
- non- healing ulcers
- infections of skin or bone
- tissue death (gangrene)
- change in the normal anatomy (deformity) of the feet
In an effort to avoid complications of diabetes, foot care is an important part of managing the disease.
Control your diabetes.
Follow the treatment regimen given to you by your doctor. Have conversations about how it is working and how it may not be working, as each regimen is individualised to the needs of the patient. Remember to maintain a healthy diet and exercise at least for 30 minutes 5 days out of the week.
Inspect your feet everyday
Check your feet for blisters, cuts, swellings, redness or any other changes that you think are odd. Look in-between your toes and on your soles as well. If you can’t see your feet have someone else look for you. CDC also recommends seeing a podiatrist (foot doctor) at least once per year.
Prevention is better than cure, so it is important to take as many steps as possible to prevent infections from happening. Wash your feet daily with luke warm water and avoid very hot water since this may cause blistering.
Dry feet thoroughly, lotion the top and bottom of the feet but avoid in-between the toes as this can cause infections due to the moist environment and germs (bacteria/ fungi) being able to grow.
Avoid cutting toe nails too low to avoid cutting the skin.
Wear socks and proper fitting shoes- even if you’re in the house- to avoid any cuts that may occur.
Read here for more information.
When to see a doctor?
You should be seeing your doctor fairly regularly to help manage your diabetes and at each visit your feet should be examined. If you notice:
- your foot or ankle swelling,
- you seem to have an infection (pain, swelling, redness, foot is hot to touch or even seeing frank puss)
- pain or tingling in the feet or ankles
- skin changes such as darkening of skin
- sores that aren’t healing
- athletes foot
- concerning nail changes (which may be a fungal infection)
you should see your doctor.
However, when in doubt check it out. Have frank and open discussions about diabetes with your doctor. I have linked several resources where you can read up more on foot care and diabetes.
Samantha C. Johnson.