Julian Varney, Senior Podiatrist · Footprints Podiatry, Burnie & Ulverstone
Saturday 14 November is World Diabetes Day. If you or someone you love lives with diabetes, you’ll know it’s not a one-day-a-year kind of condition. It’s a daily one. That’s exactly why we think of foot care the same way: small things, done regularly, that add up over a year.
This year’s World Diabetes Day theme is “Early action on diabetes”, with a focus on early diagnosis and risk reduction. For your feet, early action looks like a quick daily look, getting a small problem checked promptly, and booking regular reviews before anything has a chance to become a bigger problem.
Why 14 November?
World Diabetes Day was started in 1991 by the International Diabetes Federation and the World Health Organization, and the United Nations has recognised it as an official day since 2007. The date marks the birthday of Frederick Banting, who co-discovered insulin with Charles Best in 1922.
It’s a global day for raising awareness, but the effects of diabetes are very local. It shows up in our waiting rooms, our workplaces and our families, here on the north-west coast as much as anywhere. And while diabetes affects the whole body, the feet are often where problems show up first.
Why feet?
Over time, higher-than-ideal blood glucose levels can affect two things that matter a great deal to your feet: the nerves and the blood supply.
Nerve changes (neuropathy) can dull your sense of pain, heat and pressure. A pebble in a shoe, a blister from new boots or a small cut can go completely unnoticed, because the usual warning signal, pain, isn’t there.
Reduced blood flow can make it harder for even a small wound to heal.
Put those together and a minor injury can turn into something much more serious. According to the National Diabetes Services Scheme (NDSS), around 4,400 diabetes-related amputations are performed in Australia each year, and most of them are considered preventable with the right care. That’s the good news hidden in a hard number: this is an area where everyday habits and regular check-ups genuinely make a difference.
Last time we talked about what’s checked. This time, it’s what you do in between.
During National Diabetes Week in July we covered what a diabetes foot assessment looks at and the warning signs to watch for. If you missed it, have a read of that post too. This time we want to focus on the other 360-odd days of the year, the bits between appointments.
1. A quick daily look
Make it part of something you already do, like getting out of the shower or putting your socks on.
- Check the tops, the soles, the heels and between the toes. A mirror on the floor helps, or ask someone to take a look for you if you can’t see the bottoms of your feet comfortably.
- Look for cuts, blisters, redness, swelling, cracked skin, a change in colour, or anything that wasn’t there yesterday.
- Check inside your shoes before you put them on, too. A stray stone, a bunched-up sock lining or a rough seam can cause trouble without you feeling it.
Two minutes. That’s all it takes.
2. Keep your feet covered
Walking barefoot (around the house, at the beach, on a hot patio, or in the garden) is a common way for small injuries to start, especially if your feet don’t feel things as well as they used to. Slip-on shoes or supportive sandals are better than nothing, and thin slippers don’t protect much. As the weather warms up and the thongs come out, it’s worth thinking about what’s on your feet. (We’ll have more on summer footwear in December.)
3. Shoes and socks that fit
Shoes that are too tight, too loose, or rub in the same spot are a classic starting point for foot wounds. Look for room across the toes, a secure fit, and no rough internal seams. Socks without thick, bulky seams are a good idea too. If you’re not sure what suits your feet, bring your shoes along and we’ll take a look at them with you.
4. Know your risk level, and how often to be checked
Not everyone with diabetes has the same level of foot risk, and how often your feet should be reviewed depends on it. As a general guide, based on current guideline recommendations:
- Very low risk: a foot check at least once a year
- Low risk: every 6 to 12 months
- Moderate risk: every 3 to 6 months
- High risk: every 1 to 3 months
Aboriginal and Torres Strait Islander people are considered to be at higher risk and should have their feet checked at every clinical visit.
Your GP or podiatrist can work out which category you’re in after a proper assessment. If you’re not sure, ask.
5. Don’t wait on a wound
If you find a cut, blister or sore, don’t wait and see for a week. Keep it clean and covered, and get it looked at promptly. If an area is red, hot or swollen, has any discharge, or you feel unwell, see a doctor or go to an emergency department the same day.
A few myths worth busting
“If it doesn’t hurt, it must be fine.” With neuropathy, that’s exactly the problem. Pain is one of the body’s alarm bells, and when it’s dulled, problems can be well along before you notice. That’s why looking matters more than feeling.
“A good hot soak will sort out my feet.” Hot water, hot water bottles and heat packs are a burn risk if you can’t feel temperature properly. Foot soaks and Epsom salts can also dry out the skin and leave it cracked. Warm (not hot) water, a gentle wash and a thorough dry between the toes is the safer way.
“I’ll just cut that corn out myself.” Blades, scissors and medicated corn plasters are risky on feet with reduced feeling or circulation, because it’s very easy to break the skin without realising. A podiatrist can remove corns and calluses safely.
“Natural remedies are always safer.” “Natural” doesn’t mean harmless. Essential oils, home preparations and DIY treatments can irritate or damage skin, and they can delay getting proper care. If something’s not healing, have it looked at.
A good moment for a check-up
The end of the year gets busy, and appointments tend to book up fast before Christmas. If you have diabetes and it’s been a while since someone looked at your feet, now’s a good time to book in so you can head into the holidays (and summer) with your feet in good shape. A routine assessment is also a chance to ask about your risk level, your footwear, and anything that’s been bothering you.
Book an appointment at our Burnie clinic (127a Wilson Street) or Ulverstone clinic (56 Alexandra Street): book online
#WorldDiabetesDay #ActEarlyOnDiabetes
This article is general information only and isn’t a substitute for an individual assessment. If you have diabetes and are worried about your feet, please book an assessment or speak to your GP.
Further reading
- International Diabetes Federation: World Diabetes Day
- Diabetes Australia: diabetesaustralia.com.au
- National Diabetes Services Scheme: ndss.com.au