Diabetes affects a staggering one in 15 people, according to the charity Diabetes UK. If you’ve been diagnosed with the condition, your doctor has probably made you aware that it increases your risk of developing diabetic foot problems ranging from ulcers to Charcot Foot (characterised by weakness and deformity). That’s why it’s essential to attend diabetic foot assessments, during which a podiatrist will perform important tests to check for diabetes-related foot issues, as we’ll explain.
How High Blood Sugar Levels Affect Feet
You may be wondering how diabetes – which occurs when your body is unable to regulate blood sugar levels – could contribute to diabetic foot problems. The connection isn’t obvious, so let’s explore the issue in detail, starting with the main forms of diabetes.
- People with Type 1 diabetes, which is often diagnosed during childhood, lack insulin, because their immune system has mistakenly stopped the production of this vital hormone in the pancreas. Without insulin’s assistance, their cells can’t absorb energy-rich glucose from the bloodstream. This is a significant problem; insulin treatment is essential.
- By contrast, people with Type 2 diabetes, which is associated with being overweight, can produce insulin. However, they make too little of it or are resistant to its effects. So their cells too are deprived of glucose. Type 2 diabetes sufferers may need insulin treatment, though eating a healthier diet, exercising more and losing weight are also helpful ways to tackle the condition.
In a nutshell, whether you have Type 1 or Type 2 diabetes, you’ll experience high blood sugar levels. Unfortunately, the unabsorbed glucose can damage your blood vessels, including those responsible for supplying your nerves with essential nutrients. As a result, you could well develop poor circulation and nerve damage (also called diabetic neuropathy).
Diabetics’ feet tend to be disproportionately badly affected by those two problems. Why? Because feet are further away from the heart than other parts of the body – it’s harder to pump blood to and from them and therefore ensure enough oxygen, nutrients and protective cells from the immune system reach them. Sadly, if your circulation and feeling is impaired, you’re likely to find infections worsen rapidly and your feet are slow to heal after injuries. You’ll also find it difficult to tell when something is wrong, as your nerves will struggle to alert you to foot pain.
Tests to Identify Problems with Blood Vessels and Nerves
Because of the link between diabetes and foot problems, it’s important to examine your feet daily. Look for warning signs such as skin discolouration, changes in foot shape, weakness, hair loss, hot, cold or numb areas, wounds, and pus.
In addition, it’s in your best interests to book a diabetic foot assessment once a year or more. At Feet By Pody Canary Wharf and our other London podiatry clinics, our skilled podiatrists conduct skin, vascular and neurological checks designed to alert them to foot issues triggered by high glucose levels.
The checks are supported by three key tests:
- Doppler Test
Named after physicist Christian Doppler, this test focuses on how sound waves behave when bouncing off blood cells. Your podiatrist holds a probe against the top of your foot then interprets the sounds being produced, which are amplified by a speaker. A noise like a drum being beaten fairly vigorously indicates healthy blood flow; weaker sounds suggest poor circulation.
- Tuning Fork Test
A diagnostic tuning fork is used during our London diabetic foot assessments to check for nerve damage. Your podiatrist strikes the tuning fork against the back of their hand then brings the base into contact with your foot bones (typically by placing it on your big toe). You close your eyes and indicate when you can’t feel the vibration anymore; alternatively, the podiatrist may suppress it to see if you notice it’s stopped. If you have nerve damage, you’ll have difficulty detecting the vibration and/or its absence.
- Monofilament Test
This test focuses on nerves elsewhere in the foot, such as the sole. The monofilament is a fine piece of plastic that looks like wire. You close your eyes, and then your podiatrist carefully pushes the monofilament against your skin to check if you can feel it or are experiencing loss of sensation.
Expert Diabetic Foot Assessment in London
The three key tests are invaluable – they can alert us to diabetic foot problems before they take hold and help us to decide whether you need further tests or treatment to protect your foot health as you continue to manage your diabetes.