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What is The Diabetic Foot Clinic ?
| The Diabetic foot clinic is a specialised clinic for treatment of foot problems arising in
people with diabetes. It draws on the expertise of a team of people with skills and knowledge in
managing these problems. Access to vascular investigations and special devices for pressure relief,
advice on foot care and prevention of ulcers are some of the ways we can help keep your feet healthy
as well as achieve healing of chronic ulcers. |
Purpose:
The purpose of the diabetic foot clinic is to provide comprehensive foot care for all diabetics and includes the
management of foot ulcers, identifying patients at risk and the prevention of common foot disorders.
Who Am I Likely to See ? :
The Diabetic Foot Clinic insures optimum care through a multi-disciplinary team approach. It utilizes the expertise
of specialists in a wide variety of fields. The staff includes:
- Dr Martin Forlee - General and Vascular Surgeon
- Chris Delpierre / Andrea Blecher - Podiatrists
- Wound Care Nurse Specialist
We have access if necessary to Orthotists, Endocrinologists, Diagnostic Radiology and Orthopaedic and Plastic Surgeons.
What happens at the Clinic ?
You will be examined by the Doctor and Podiatrist. It is likely that your circulation and sensation will be assessed.
If necessary a photograph will be taken for our records. We will decide on a plan of management and you may be
required to have further tests such as blood tests, wound swabs, an X-ray or scan. If you have an ulcer or open
wound, a dressing may then be applied.
What Do I need to Bring?
DO bring your usual footwear with you as this provides useful information. If you have been started on antibiotics
by your doctor bring these with you. If you monitor your blood sugar, please bring your record book with you.
If your doctor or Practise Nurse has provided you with any dressings, brings these as well.
Treatment:
Treatment consists of a multi-disciplinary approach to diabetic foot care. Treatment is focused on prevention of
diabetic foot disorders through identification of the foot at risk, the use of nail and callus care, education
and proper footwear. Treatment may also address the healing of diabetic foot wounds.
Who would benefit from being seen in the Diabetic Foot Clinic?
- All newly diagnosed type II diabetics
- All type I diabetics > 5 years
- Anyone who has a persistent callous or foot ulcer that is not healing within 2-3 weeks with conservative management.
What are important indicators of a problem with a diabetic foot?
Persistent pain in the foot, build up of callus on the foot, a non healing sore on the foot or ankle, and
continuing drainage from an ulcer are all indicators of a potentially serious problem with the foot
Why do Diabetics Develop foot problems?
Ulcers most often occur on the ball of the foot or on the bottom of the big toe. Ulcers on the side of the foot,
due to poorly fitting shoes, are also common. Most diabetics have some foot-related problems after age 40 or after
ten years with the illness, and the likelihood of these problems increases with age.
- Peripheral neuropathy, or loss of sensation, is the major cause of diabetic foot ulcers and amputation.
- Diabetes can make the skin on your feet drier and more likely to peel or crack.
- Diabetics are more likely to form calluses on their feet due to high-pressure areas under the
foot and, if untreated, these calluses may turn into ulcers.
- Diabetes frequently causes poor blood flow or circulation in the legs and feet, which hinders the
body’s ability to fight infection and heal.
- Diabetics are more subject to infections because elevated blood sugar limits the effectiveness of cells that fight bacteria
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Who Is At Risk ?
- Diabetes is the commonest cause of non-traumatic lower limb amputations
- 15% of diabetics will develop a lower limb ulcer during their lifetime
- 7 – 20 % of these people will require an amputation
- Foot ulcers precede 85% of lower limb amputations in diabetics
Why is it important to take care of the feet and prevent amputation?
Studies have shown that 50% of patients who have an amputation undergo a second amputation within 2-5 years.
60% of patients who undergo amputations are dead in 5 years.
Amputations above the knee are associated with higher mortality rates than amputations below the knee.
What can I do to Prevent Diabetic Foot Complications ?
Daily exam:
- Look for cuts or sores: use a mirror to see the bottom of the foot or ask a friend or family member to help
- Check for warning signs: redness, swelling, warmth, pain, slow healing, dry cracks, bleeding corns or calluses, tenderness, loss of sensation
Daily care:
- Wash your feet daily and dry them carefully, especially between the toes
- Use talcum powder
- Do not cut corns or calluses - use a foot care specialist if needed
- Keep toenails trimmed and smooth
- Promptly treat dry skin or athlete's foot
- Keep blood glucose under control
- Protect your feet from heat and cold – test bath water with your hand to make sure it is not too hot. Never use hot water bottles, heating pads or electric blankets.
Get a regular foot exam by your healthcare provider:
- Once a year for everyone, every 3 - 6 months for people at high risk
- Take off shoes and socks at every doctor visit
- Check for sensation and foot pulses
- Ask for a risk evaluation
Footwear:
- Do not walk barefoot, even indoors and always wear socks.
- Check inside your shoes before wearing them
- Don't wear shoes or socks that are too tight
- Wear well-cushioned shoes
- Buy shoes that are roomy and "breathe": they should be comfortable at the time of buying
- People with diagnosed foot problems may need special footwear
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