Diabetic foot: how can it impact my life?

Diabetic foot refers to a range of foot complications in individuals with diabetes, including infections, ulcers, and Charcot foot, caused by nerve damage and poor circulation, often leading to severe complications and amputation if left untreated.

Leading consultant orthopaedic foot and ankle surgeon Mr Nijil Vasukutty explains the signs of diabetic foot, how it can affect daily life, and the do’s and don’ts of the condition.

What are the signs of diabetic foot?                   

Diabetic foot is essentially an umbrella term covering a variety of conditions related to foot health in people with diabetes. This includes foot infections, ulcers, and a particularly complex condition known as Charcot foot. Charcot foot involves bones becoming softer than normal, leading to fractures and dislocations, often without the patient realising, due to impaired sensation caused by nerve damage from diabetes.

In essence, Charcot foot results in fragile bones, leading to deformities and difficulties with mobility and function. The initial signs of Charcot foot include swelling and redness, which can sometimes be mistaken for an infection.

In severe cases of diabetic foot, toes may darken or become black due to loss of blood supply. Early warning signs may include blisters, calluses, or small injuries that can escalate into infections or ulcers, particularly in those with long-standing diabetes.

It is important to note that a small cut or injury, which may be dismissed as trivial by many, can have significant consequences, particularly for those with diabetes. Such seemingly minor injuries can lead to foot infections or ulcerations. In diabetic individuals, the lack of normal sensation means they may not realise they have sustained such an injury.

Reduced resistance to infection and diminished blood flow impede the body's ability to fight off infections, resulting in ulceration and subsequent infection. Recognising the signs of diabetic foot infections and being vigilant for warning signs is crucial for managing this condition effectively.

How does diabetic foot affect everyday life?

Diabetic foot can be a life-changing event for the patient, impacting their management of diabetes, blood sugars, and overall lifestyle. Dietary changes are already part of diabetes management, but with the development of a diabetic foot infection, further lifestyle adjustments become necessary.

Mobility and function are affected, with patients potentially unable to use normal footwear, instead requiring specialised options like orthosis or large boots. This alteration can impact daily activities, work, and social life, as cumbersome footwear may be required.  As a result, it may also lead to limitations in physical labour and safety concerns may arise.

Additionally, controlling diabetes may require more stringent lifestyle changes to support foot health, including regular antibiotic treatments and frequent appointments with healthcare professionals such as podiatrists, nurses, or specialists. Patients must adapt their lives and work around these requirements, as explained by their healthcare professional, whether that be a podiatrist, orthopaedic surgeon, or diabetes physician.

Compliance with medical instructions, regular monitoring, and avoiding missed appointments are essential to prevent complications and ensure effective management.

What should I do or not do to help my diabetic foot?

As for "don'ts," quitting smoking is particularly emphasized due to its detrimental effects on foot healing and surgical outcomes. Overall, adherence to medical advice and proactive foot care are paramount in managing diabetic foot conditions and minimizing their impact on patients' lives.

There are several do's and don'ts to adhere to regarding diabetic foot care. Firstly, it's imperative to follow the instructions of the specialist diligently, whether it's a podiatrist, orthopaedic surgeon, or general practitioner (GP) overseeing your treatment.

Protecting your foot is paramount; use prescribed footwear and avoid walking if advised against it. While efforts are made not to overly restrict patients, following instructions rigorously is crucial. As previously mentioned, you should ensure that you attend each appointment with your doctor or nurse, as even a couple of missed appointments or changes can significantly impact outcomes.

As for don'ts, quitting smoking is particularly emphasised due to its detrimental effects on foot healing and surgical outcomes. Quitting smoking is vital for optimal foot health and treatment outcomes.

If you are suffering from diabetic foot and would like to book a consultation with Mr Vasukutty, do not hesitate to do so by visiting his Top Doctors profile today