Diabetics… with feet of clay

[22 April 2009 - 08h24]
[mis à jour le 24 April 2009 à 10h24]

Every year in France, 8,000 diabetics (including 1,500 under the age of 60) undergo amputation of a lower limb. This figure is all the more unacceptable when we consider that this type of surgery is largely avoidable! Providing, of course, that diabetics pay careful attention to the health of their feet.

Beware small lesions In general terms, diabetes causes damage to the arteries, blood vessels and nerves. This makes the feet particularly vulnerable (likewise the eyes and kidneys, which are both highly vascularized) and can aggravate existing wounds, cause pain and, more seriously still, loss of sensitivity…

In a great many cases in fact, it is this insensitivity that prevents diabetics noticing foot lesions, whether large or small. As a result, some sufferers do not feel the presence of a corn, callus, crack, cut, broken skin or fungal infection on their feet.

These wounds can be difficult to heal and can spread and become infected. In extreme cases this can lead to amputation. Each year in France, 9,500 lower limb amputations are carried out on 8,000 diabetics. According to the French Diabetes Association (the AFD), “one diabetic is at risk of amputation”…

Prevention is essential. Very often, however, these complications of diabetes can be avoided. If you are diabetic you need to be vigilant. Make a point of checking for the slightest lesion or the smallest sign of infection as early as possible. Do this by:

washing your feet every day, including your toes, and make sure you dry them very carefully to avoid fungal infection;
examining daily the soles of your feet, the gaps between your toes, and your nails, looking for any sign of a cut or graze. If necessary use a mirror or ask someone to help you;
not cutting your toenails too short;
choosing suitable, comfortable shoes;
choosing socks made from natural fibres without inside seams. And change them every day;
never wearing shoes without socks;
never walking barefoot;
not using a hot water bottle. It can make the skin on your feet dry and lead to cracks;
visiting your GP or chiropodist for a check-up at least once a year. You are now entitled to these consultations and your health insurance provides better cover for them.

If you have a foot wound… show it to your doctor straight away. As AFD advisors point out, “if your foot is infected, you need to follow a balanced diet, stop smoking (because smoking affects blood circulation), and avoid other risk factors” such as alcohol and foods that are high in sugar and fat. It is also worth remembering that today there are medical products that speed up the healing process and can be helpful to diabetics suffering from chronic foot ulcers.

Source : From our special correspondent at the 35th Congress of the French Language Association for the Study of Diabetes and Metabolic Diseases (ALFEDIAM), 17-20 March 2009, Strasbourg – French Diabetes Association – BEH, no.10/2006.

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