Footcare and Diabetes

What is diabetes?

Diabetes mellitus (just called diabetes from now on) occurs when the level of glucose (sugar) in the blood becomes higher than normal. There are two main types of diabetes – type 1 diabetes and type 2 diabetes

Understanding blood glucose and insulin
After you eat, various foods are broken down in your gut into sugars. The main sugar is called glucose which passes through your gut wall into your bloodstream. However, to remain healthy, your blood glucose level should not go too high or too low.

So, when your blood glucose level begins to rise (after you eat), the level of a hormone called insulin should also rise. Insulin works on the cells of your body and makes them take in glucose from the bloodstream. Some of the glucose is used by the cells for energy, and some is converted into glycogen or fat (which are stores of energy). When the blood glucose level begins to fall (between meals), the level of insulin falls. Some glycogen or fat is then converted back into glucose which is released from the cells into the bloodstream.

Insulin is a hormone that is made by cells called beta cells. These are part of little ‘islands’ of cells (islets) within the pancreas. Hormones are chemicals that are released into the bloodstream and work on various parts of the body

What is type 1 diabetes?
In type 1 diabetes the beta cells in the pancreas stop making insulin. The illness and symptoms develop quickly (over days or weeks) because the level of insulin in the bloodstream becomes very low. Type 1 diabetes used to be known as juvenile, early onset, or insulin-dependent diabetes. It usually first develops in children or in young adults. Type 1 diabetes is treated with insulin injections and diet.

What is type 2 diabetes?
With type 2 diabetes, the illness and symptoms tend to develop gradually (over weeks or months). This is because in type 2 diabetes you still make insulin (unlike type 1 diabetes). However, you develop diabetes because:.

  • You do not make enough insulin for your body’s needs.
  • The cells in your body do not use insulin properly. This is called ‘insulin resistance’. The cells in your body become resistant to normal levels of insulin. This means that you need more insulin than you normally make to keep the blood glucose level down, OR
  • A combination of the above two reasons.

Type 2 diabetes is much more common than type 1 diabetes.

There are an estimated 1 million people in the UK that are diabetic and are not aware of it.

Here at Beddington Podiatry Practice your initial assessment will include screening for sensory loss (Neuropathy) and vascular insufficiency (reduced blood flow) which are diagnostic markers for diabetes. The results along with your history and symptoms may indicate you have diabetes and a screening report will be sent to your doctor to follow up and treat you.

Your feet are a very important part of your future care, and should never be overlooked or neglected. Unfortunately because of the funding cuts in the NHS many diabetic patients have been refused chiropody / podiatry because they are not “high risk” patients and are left to fend for themselves.

Because of the insidious nature of diabetes, complications can develop un-noticed by the patient and only become evident when a well-meaning relative or untrained person causes injury by inappropriate nail cutting or cutting the skin with unsterile instruments, the application of “corn plasters /liquids etc.

The healing time is dramatically extended in diabetics so to prevent any injury is imperative.

It is an unfortunate fact that in the UK alone there are 100 amputations PER WEEK performed on diabetics.
Many of these are as a result of injury that leads to ulceration, gangrene and death of the tissue.

We recommend an annual visit as a minimum for a foot health check to ensure the symptoms are not progressing and regular care if you have  foot pathology or are unable to reach your feet/ your nails are too tough to manage etc.

Other risk factors for type 2 diabetes include:

  • Having a first-degree relative with type 2 diabetes. (A first degree relative is a parent, brother, sister, or child.)
  • Being overweight or obese.
  • Having a waist measuring more than 31.5 inches (80 cm) if you are a woman or more than 37 inches (94 cm) if you are a man.
  • Having impaired glucose tolerance. (Impaired glucose tolerance is when your blood glucose levels are higher than normal but not high enough to have diabetes.)
  • Having diabetes or impaired glucose tolerance when you were pregnant.

What are the symptoms of type 2 diabetes?
As already mentioned the symptoms of type 2 diabetes often come on gradually and can be quite vague at first. Many people have diabetes for a long period of time before their diagnosis is made.

The four common symptoms are:.

  • Being thirsty a lot of the time.
  • Passing large amounts of urine.
  • Tiredness.
  • Weight loss.

The reason why you make a lot of urine and become thirsty is because glucose leaks into your urine which ‘pulls out’ extra water through the kidneys.

As the symptoms may develop gradually, you can become used to being thirsty and tired and you may not recognise that you are ill for some time. Some people also develop blurred vision and frequent infections, such as recurring thrush. However, some people with type 2 diabetes do not have any symptoms if the blood glucose level is not too high. But, even if you do not have symptoms, you should still have treatment to reduce the risk of developing complications.

Here at Beddington Podiatry practice ALL instruments are sterilised using the latest technology autoclaves and ultrasonic cleaning equipment for every individual patient to minimize the risk of infection. Derek Harland’s experience in your treatment regimes ensures your safety and continuing wellbeing.

REMEMBER Prevention is always better than cure!! 

Never more so than in the case of diabetic foot care.

Don’t become a statistic through lack of knowledge or inappropriate treatments.

Be sure and be safe with an HPC Registered Podiatrist, here at Beddington Podiatry.