DIABETES TYPE 1 OR 2
SYMPTOMS
EVALUATION
TREATMENT
WHY PODIATRY IS ESSENTIAL
FOR PEOPLE WITH DIABETES?
People with diabetes often have higher levels of blood glucose, which affects your circulation and nervous system. The reduction of blood supply to your feet can cause damage to your nerve endings, something known as peripheral neuropathy.
Peripheral neuropathy can lead to insensitivity, which means you lose the ability to feel pain and distinguish hot or cold. So you may not notice if you have a minor cut, sore or wound. In addition, poor circulation makes it difficult for your body to heal, so a minor problem left unchecked could lead to serious complications including foot ulcers, foot infections, and even amputation.
Other complications for people with peripheral neuropathy are a loss of balance and coordination, and muscle weakness in the feet.
The assessment consists of inspection, palpation, and a short neurological examination. The entire foot should be fully inspected for signs of ischemia, deformity, oedema, callus, skin breakdown, infection, and necrosis. Leg and foot pulses should be palpated. Peripheral neuropathy can be detected by performing a simple sensory examination.
Monofilament test. We will use a soft nylon fiber called a monofilament, comprehensive testing for nerve damage. This will help you understand if you have nerve damage.
Tuning fork and visual perception tests (VPT). We will place a tuning fork against your foot and toes to see if you can feel the vibration it produces.
Doppler test We will use a doppler ultrasound which is a noninvasive test that can be used to estimate the blood flow through your blood vessels by bouncing high-frequency sound waves (ultrasound) off circulating red blood cells.
A Doppler ultrasound may also help diagnose many other conditions, including:
Blood clots
Poorly functioning valves in your leg veins, which can cause blood or other fluids to pool in your legs (venous insufficiency)
A blocked artery (arterial occlusion)
Decreased blood circulation into your legs (peripheral artery disease)
