Diabetic conditions affecting the legs and feet

The feet and legs are common sites for complications in people with diabetes mellitus and for this reason good foot care is very important. An injury to the foot or leg can be painful, but in people suffering from diabetic neuropathy (nerve damage) the sensations are dulled and minor injuries often go undetected and untreated, potentially leading to more serious damage.

Loss of temperature sensation is also a significant risk factor for injury in people with diabetes. This can result in a person being unaware that the bath water they are stepping into is scalding them. They may also be at risk of developing severe burns after sitting too close to a heater.

Special attention is needed to prevent circulatory disorders and infections that commonly occur in the lower extremities of people with diabetes. Areas with poor circulation heal badly and, if left unattended, such injuries may develop into ulcers or even become gangrenous.

Do not ignore pain in the feet or legs as this may indicate a problem. Corn plasters should not be used as they may cause foot ulcers.

Good foot care

Good foot care is vitally important for people with diabetes. Every day, wash your feet in warm (not hot) water. If you notice a callus forming, you can try to gently remove it (for example, with a pumice stone). However, once formed, calluses should only be treated by professionals. After washing, apply a moisturiser to your feet, but avoid moisturising between your toes. When you cut your toenails, cut straight across and file down any sharp edges.

Always wear shoes and socks, and choose your shoes carefully. Shoes should be large enough to be comfortable, but not large enough to be slipping off. They should have resilient (but not soft) insoles, and be smooth on the inside, with no rough areas.

Check your feet each night, looking for:

• dry, scaly, red, itching or cracked skin;

• areas where something has been rubbing on your feet;

• blisters;

• cuts or abrasions;

• corns or calluses;

• infections;

• thickened or discoloured nails;

• blueness or any swelling; and

• any red, hot or swollen areas.

If your vision is poor, get someone to check for you.

Any breaks in the skin need to be treated straight away, so see your doctor or podiatrist. Also, try to work out what might have caused the problem so that you can prevent it happening again. If one of your feet is hot and swollen, check it again the next day — see your doctor if it remains hot and swollen.

Your feet should also be examined regularly by a doctor, diabetes specialist or podiatrist. Your doctor or podiatrist can advise you on foot care and also on the selection of appropriate footwear.

Corns and calluses

Painful areas on the feet can be a great source of misery, making walking uncomfortable. Sufferers are often reluctant to take regular exercise.

Among the most common causes of sore feet are calluses and corns. These are raised areas of local thickening of the surface layer of the skin. This layer is known as the keratin layer. When it becomes thickened the condition is known as hyperkeratosis.

Calluses and corns are usually found in places where there is friction or pressure. They are usually the result of badly fitting shoes, but can also occur if your feet are abnormally shaped. They are sometimes found on other parts of the body where friction occurs, for example, on the fingers of guitar players.

Calluses are bigger than corns and are usually found on the bottom (sole) of the foot, either around the heel or around the front of the foot at the base of the first and fourth toes — places where pressure occurs.

Corns are smaller and often have a central core, or ‘plug’, of keratin, which can be seen. The top of the fifth toe (where it gets squashed by tight shoes) is the most common site for a corn. Sometimes they are found between the toes, where they can be extremely painful.

Treatment of corns and calluses

The best way to treat corns and calluses is to remove the hard keratin on a regular basis. This can be done by ‘shaving’ with a sharp, preferably sterile, blade. This is best done by a doctor or podiatrist. For those who prefer the do-it-yourself approach, a pumice stone can be used to do the job. Various preparations are available to help soften the areas of hyperkeratosis. These usually contain salicylic acid, which is present in corn plasters.

Although the discomfort of calluses and corns is often easily fixed, the problem will inevitably come back if the underlying problem, usually wearing the wrong pair of shoes, is not corrected. If changing shoes does not help, seeing a podiatrist may be helpful.

Athlete's foot is a common infection caused by a fungus. It most often affects the space between the toes. Symptoms include itching, burning, and cracked, scaly skin between your toes.

You can get athlete's foot from damp surfaces, such as showers, swimming pools, and locker room floors. To prevent it

• Keep your feet clean, dry, and cool
• Wear clean socks
• Don't walk barefoot in public areas
• Wear flip-flops in locker room showers
• Keep your toenails clean and clipped short

Treatments include over-the-counter antifungal creams for most cases and prescription medicines for more serious infections. These usually clear up the infection, but it can come back.

Each step you take involves a complex network of bones, muscles, tendons, and ligaments. This, combined with all of the weight they carry, explains why feet can have problems. To keep your feet healthy

• Examine your feet regularly
• Wear comfortable shoes that fit
• Wash your feet daily with soap and lukewarm water
• Trim your toenails straight across and not too short

Your foot health can be a clue to your overall health. For example, joint stiffness could mean arthritis. Tingling or numbness could be a sign of diabetes. Swelling might indicate kidney disease, heart disease, or high blood pressure.

Good foot care and regular foot checks are an important part of your health care. If you have foot problems, be sure to talk to your doctor.

Dubai Podiatry Centre has launched its annual Foot Health Campaign for Children in its local Emirate of Dubai, by running a free foot health check-up for children’s feet and legs during October and November 2013.

Dubai Podiatry Centre has launched its annual Foot Health Campaign for Children in its local Emirate of Dubai, by running a free foot health check-up for children’s feet and legs during October and November 2013.

Fungal and Bacterial Conditions, including athlete's foot, occur because our feet spend a lot of time in shoes - a warm, dark, humid place that is perfect for fungus to grow. Fungal and bacterial conditions can cause dry skin, redness, blisters, itching, and peeling.

Fungal and Bacterial Conditions, including athlete's foot, occur because our feet spend a lot of time in shoes - a warm, dark, humid place that is perfect for fungus to grow. Fungal and bacterial conditions can cause dry skin, redness, blisters, itching, and peeling.