InStep Foot Clinic

The Specialists in
Podiatric Medicine

Opening Hours

Monday: 8.00am - 5.00pm
Tuesday: 9.00am - 4.00pm
Wednesday: 8.00am - 8.30pm
Thursday: 8.00am - 6.00pm
Friday: 8.00am - 2.00pm


01780 783982

Diabetic Foot Care

Understanding Diabetes

The body uses energy in the form of a simple sugar called glucose. It obtains glucose from various foods such as carbohydrate. The amount of glucose or ‘sugar’ in the blood has to be kept at a steady level; a hormone called insulin does controls this function. Insulin is released from the pancreas in response to food, and this regulates the blood sugar level.

Diabetes Mellitus is a condition where the level of ht sugar in the blood is not controlled effectively by insulin. Sugar accumulates in the blood and passes through the kidneys producing sugar in your urine.

How many types of Diabetes are there?

There are two types of diabetes. These are:

• Type 1 Diabetes. This needs daily injections of insulin together with a healthy diet. The pancreas produces no insulin. This type of diabetes usually occurs in younger people, but can occur at any age.
• Type 2 Diabetes. The pancreas is still able to control the amount of sugar in the blood. This type of diabetes usually occurs in alter life. Controlling diet and weight are veryimportant. Treatment may also require tablets and sometimes insulin.

Diabetes is a life-long condition.
A healthy diet, regular exercise and regular GP, nurse and Podiatry appointments are essential.

How can Diabetes Affect Your Feet?

There are three main ways in which your feet may be affected. These symptoms can exist together or separately. They are:

Ischaemia (reduced circulation)
This occurs when the arteries have their inner walls covered by a fatty substance, atheroma. This means there is less room for the blood to flow down to the foot. In severe cases a blockage may occur. Smoking makes this problem much worse. A good blood supply is essential to maintain healthy skin and tissues, and also to heal any open wounds. A Doppler is used at InStep Foot Clinic at least annually, to check your blood supply.

This is where the nerve and the foot and lower leg have been damaged by the diabetes and y our sensa tion is impair ed. Y ou may be unable to tell the difference between hot and cold or feel sharp objects. The skin can often appear dry. We will check this at least annually.

Changes in Foot Shape This is likely to occur in association with ischaemia or neuropathy. The nerves controlling the muscles do not work effectively and this can result in clawing of the toes. Therefore the balls of the feet also become more prominent. This causes changes in the way you stand and walk, causing abnormal pressure areas and calluses.

All patients with diabetes receive a comprehensive diabetic foot health check on at least an annual basis in accordance with NICE Clinical Guideline 10. This service is included free within your routine treatment.

How to Prevent Foot Problems

1. General measures. Ensure you do everything to maintain good control of your blood sugar. Stop smoking.
2. Daily foot checks. You may not feel an injury to your foot so inspect your feet everyday, using eyes, hands, mirror.
3. Nail cutting. Arrange to have your nails cut by our Podiatrist, just file nails.
4. Treating hard skin. Remove this using only a foot file and apply a foot cream.
5. Bathing. Wash your feet regularly and thoroughly with warm water and soap. Make sure you dry them properly.
6. Socks. Wear a clean pair of wool of cotton, natural fibre socks everyday.
7. Footwear . Always make sure your shoes have a round, wide, deep toe box which is the same shape as your foot. Shoes must have fasteners to ensure a good fit, don't fasten them too tightly. Choose leather with less than a 1” heel.
8. Heat. Your feet ma y not be able to distinguish hot from cold. Do not use hot water. Any burns will not heal easily.

Please DO NOT:
• Use sharp objects to remove hard skin.
• Ignore any changes in your feet.
• Wear badly fitting shoes.
• Use corn plasters.
• Walk barefoot.