What Happens at an Annual Diabetes Foot Health Check?
Generally speaking, we don’t tend to pay too much attention to our feet. But as a person living with diabetes, one of the most important dates in your diary should be your annual foot health check. Along with regular eye checks and consults with your GP and diabetes educator, it should form an essential part of your personal diabetes management program.
If you’re not familiar with what a foot health check involves, don’t worry – because we’re about to bring you up to speed. Podiatrist Lauren Robinson has more than 10 years’ experience helping clients manage diabetes and diabetes-related foot complications – so we asked her for the lowdown on what to expect.
Where can I get a foot health check?
First things first: you need to find yourself a good local podiatrist. “Your GP or diabetes educator can usually recommend someone for you, but all podiatrists are qualified to carry out foot health checks: it’s a major part of what we do and what we’re trained in,” Lauren explains. “While you can also ask your GP or diabetes educator to assess the overall health of your feet, it’s likely that they will refer you to a podiatrist to carry out any non-medical treatment or maintenance. We can also provide you with a self-management program to keep your feet in shape in between health checks.”
What’s involved in an annual foot health check?
A diabetes foot health check is exactly as it sounds – it’s an assessment to check the overall wellbeing of your feet and inspect them for any potential health problems. “We look at a number of different factors to assess foot health,” she said. “Blood flow is a big one – we want to check the volume and quality. Ideally, circulation should be normal, with no swelling in the feet or lower limbs.
“The next thing we check for is sensation using a tuning fork. How much feeling you have in your feet is a major indicator of overall foot health. One of the side effects of diabetes is neuropathy, which occurs when the nerve endings become damaged and is often localised to the feet and lower extremities. It can present in two extremes: a lack of sensation and numbness or heightened sensitivity leading to considerable pain.
“Naturally, if you have limited sensation in your feet, you’re more likely to cause injury to yourself – and fail to notice when you do! That’s why it’s really important to keep your feet protected by wearing close-toed shoes.”
In addition, your podiatrist will inspect your feet for any ulcers, cuts, corns or calluses that need attention. “Wound care is extremely important for people living with diabetes,” explains Lauren. “Diabetes weakens your body’s ability to heal wounds, which means even a small cut or rough skin patch has the potential to develop into a nasty infection very quickly if left unchecked. If your podiatrist notices any problem areas, he or she will be able to assess them for you, provide you with advice for self-care and treat them on the spot if necessary.”
So what happens next?
Once your check is completed, you’ll be provided with a report for your GP and placed in a risk category that indicates how likely you are to develop foot-related complications.
“Your risk category is assessed by looking at two areas: (a) the outcome of your foot health check and (b) whether you have any additional risk factors such as smoking or high blood pressure.
“If your feet are healthy and you have no other risk factors, you’ll be considered low risk and placed in Category 1. If your circulation and sensation are good but there are risk factors present, you’ll be placed in Category 2. Category 3 is for high risk patients who need to be on high alert for foot-related complications and need much closer monitoring by health professionals.”
If your report highlights any areas of concern, your GP will investigate further and prescribe antibiotics if infection is detected. Where there are concerns regarding circulation, you may be referred to a vascular specialist who will examine your legs with a doppler – this maps circulation from the hips down.
I’ve never had a foot health check – what are the signs that there may be a problem?
If you’ve never had your feet examined by a health professional, you should arrange to do so – however, if you’re experiencing any of the following symptoms, see your GP without delay:
- Cramping in the calf or lower leg on a regular basis, generally when in bed or lying down
- Swelling and puffiness in the lower legs and feet
- Skin that is purpley-red in colour
- Skin that is either over-sensitive or feeling numb
- Hair not growing
Lauren Robinson is a Senior Podiatrist with almost 10 years’ experience helping patients manage their diabetes.
She has been engaged by Sanofi to provide regular expert commentary for Diabetes Care. The views and opinions expressed in this article are those of the expert and do not necessarily reflect the view of Sanofi.