News Page

Diabetic Foot: Screening and Management

Diabetes is a chronic condition that affects millions of people worldwide. Among its many complications, one of the most alarming is diabetic foot—a condition that can lead to severe foot health issues, including chronic ulcers and even amputations, if not managed properly. However, with the right knowledge and preventive measures, you can safeguard your feet and keep your mobility intact. 

Risk Factors & Pathophysiology

Diabetic foot ulcers often develop due to a trifecta of issues: nerve damage, injuries that lead to infections, and problems with blood flow.  Nerve injuries can lead to foot deformities like hammer toes, and decreased sensation may cause you to overlook injuries, as the protective fat pads on the soles of your feet wear down.

Several risk factors contribute to the development of diabetic foot ulcers, including:

Screening & Diagnosis 

Early detection is key to preventing serious complications from diabetic foot issues. 

1. Personal Information: Your healthcare provider will ask questions regarding:

• Medical History: This involvesthe management of your diabetes, any other health conditions you may have, and your current symptoms.
• Medications: A review of the medications you are currently taking.
• Footwear: Your health care provider may examine your shoes for proper fit and inquire about other types of footwear, as poorly fitting shoes can lead to blisters, calluses, and ulcers.

2. Skin Examination: Your doctor will assess:

• The condition of your feet, checking for dryness, cracks, calluses, blisters, ulcers, and any other abnormalities.
• Your toenails for signs of cracks or fungal infections.
• The temperature of your feet to ensure adequate blood circulation.

3. Nerve Examination: Your doctor will perform several tests to evaluate nerve function and sensation in your feet:

• Monofilament Test: Your health care provider will gently run a delicate nylon strand (monofilament) across your foot and toes while you close your eyes. When you feel the strand, you will signal.
• Tuning Fork and Vibration Perception Threshold Tests (VPT): A tuning fork or vibrating device will be placed on various areas of your foot and toes to check your ability to perceive vibrations.
• Pinprick Test: Your provider will lightly press a small pin against your big toe to assess your sensation. The pin will not penetrate the skin.
• Ankle Reflexes: A small hammer will be used to tap your Achilles tendon, which should cause your foot to jerk slightly if your nerves are functioning correctly.

4. Musculoskeletal Examination: Your provider will look for issues such as:

• Bent or overlapping toes
• Bunions
• A rocker shape on the bottom of your foot (known as Charcot Foot)

5. Vascular Examination: To evaluate blood circulation in your feet, your provider may:

• Palpate the pulses in your foot and ankle.
• Assess the blood pressure measurements in your arms and ankles. If your ankle's blood pressure is lower than your arms blood pressure, it is indicative of reduced blood flow to your foot.

Don't forget—self-checks are essential! Patients are also encouraged to perform their own foot checksto catch problem early. If any problems are noticed, it’s crucial to seek medical advice promptly.

The Young Townson FootSkin Hydration Scale for Diabetic Neuropathy:

This is a pictorial scale that enables you to record dryness of your foot skin. If you have neuropathy and your foot skin looks like the photos in Level 3 or 4, you are at high risk of foot ulceration and you should consult your doctor immediately.

Prevention with Once Heel Balm

One of the simplest ways to prevent foot ulcers is by using a specialised heel balm. Once Heel Balm lowers the chance of callus formation by keeping the skin hydrated and healthy. Complications that can result in ulcers are less likely to occur in a foot that is properly moisturised.

Once Heel Balm contains 25% urea which not only hydrates the skin but also helps to exfoliate the foot skin. Once Heel Balm also contains other ingredients that help repair damaged foot skin. Patients with diabetes who have regular treatment can avoid dryness and cracking, which can serve as an entry point for infections.

Conclusion: Taking Charge of Your Foot Health

In conclusion, diabetic foot issues can have serious consequences, but people can greatly lower their risk by participating in regular screenings, adopting effective treatment strategies, and utilizing preventative measures like Once Heel Balm, you can maintain your skin and ensure your foot skinhealth.

Bibliography:

Bandyk DF. The diabetic foot: Pathophysiology, evaluation, and treatment. Semin Vasc Surg. 2018 Jun-Dec;31(2-4):43-48. doi: 10.1053/j.semvascsurg.2019.02.001. Epub 2019 Feb 6. PMID: 30876640.

Seed S, reviewed by Sheikh Z. Diabetic Foot Problems.[Internet] [cited March 07,2025]. Available at:https://www.webmd.com/diabetes/foot-problems

Your Feet and Diabetes. CDC-Diabetes. May 15, 2024.[Internet] [cited March 07,2025]. Available at:https://www.cdc.gov/diabetes/diabetes-complications/diabetes-and-your-feet.html

Sharma R et al. Diabetic Foot Disease—Incidence and Risk Factors: A Clinical Study. The Journal of Foot and Ankle Surgery (Asia-Pacific), January-June 2016;3(1):41-46.

Diabetic Foot Exam. Medline Plus. May 9, 2023. [Internet] [cited March 07,2025]. Available at:https://medlineplus.gov/lab-tests/diabetic-foot-exam/#:~:text=What%20happens%20during%20a%20diabetic,Pinprick%20test.

Federici A, Federici G, Milani M. Use of a urea, arginine and carnosine cream versus a standard emollient glycerol cream for treatment of severe xerosis of the feet in patients with type 2 diabetes: a randomized, 8 month, assessor-blinded, controlled trial. Curr Med Res Opin. 2015 Jun;31(6):1063-9. doi: 10.1185/03007995.2015.1037731. PMID: 25851453.

Dermatonics. [Internet] [cited March 07,2025]. Available at: https://www.dermatonics.co.uk/pages/professionals

Dermatonics. (n.d.). Dermatonics Professionals