I have Diabetes, but why do I need to see a podiatrist?
Diabetes rates are on the rise, and if you have it, there’s no shame in that. However, it’s not something to ignore. Early lifestyle changes and proactive treatment can make a significant difference in preventing complications down the line.
Firstly, what is Diabetes?
Diabetes is a condition that affects the body’s ability to regulate blood glucose (also known as blood sugar), often causing levels to become too high.
Glucose is the body’s main source of energy and comes from the food we eat. Insulin—a hormone produced by the pancreas—helps the body use this glucose for energy. In people with diabetes, the body either doesn’t produce enough insulin, doesn’t produce any at all, or isn’t able to use the insulin effectively.
As a result, glucose remains in the bloodstream instead of being absorbed by the body’s cells.
You may have heard of two main types of diabetes: Type 1 and Type 2. While they can appear similar in their symptoms and long-term health impacts, the causes and treatments differ.
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Why me?
Type 1 diabetes (insulin dependent)
Type 1 diabetes is an autoimmune condition that cannot be prevented. In this form of diabetes, the immune system mistakenly attacks and destroys the insulin-producing cells in the pancreas. As a result, the body is no longer able to produce insulin.
Type 1 diabetes is most commonly diagnosed in children and young adults. Once diagnosed, individuals must manage their condition with regular insulin injections to keep their blood sugar levels within a healthy range.
Type 2 diabetes
With Type 2 diabetes, the mechanism is a little less clear-cut compared to Type 1. In this form of diabetes, the body either doesn’t produce enough insulin, doesn’t use insulin effectively, or both. This leads to poor glucose uptake by the body’s cells, resulting in elevated blood sugar levels.
Several factors increase the risk of developing Type 2 diabetes, including poor diet, physical inactivity, being overweight, a family history of diabetes, and certain ethnic backgrounds.
Treatment for Type 2 diabetes varies from person to person. Some individuals may require daily medication, while others can manage the condition through lifestyle changes alone. Regular check-ups with a healthcare professional are essential to determine the most appropriate treatment plan.
How can Diabetes affect my feet?
While some people with diabetes may not experience serious complications, unmanaged or poorly controlled diabetes can significantly impact overall health—especially when it comes to the feet. High and fluctuating blood glucose levels can cause damage over time, increasing the risk of serious foot problems. Two of the most common complications include:
1. Microvascular and Macrovascular Disease
Diabetes can damage both small (microvascular) and large (macrovascular) blood vessels in the legs and feet. This reduced blood flow leads to poor circulation, which impairs healing and increases the risk of infection. It can also cause leg fatigue, muscle pain, and, in more severe cases, tissue damage.
2. Nerve Damage (Neuropathy)
Just like blood vessels, the nerves in the feet and lower legs can be affected by prolonged high blood sugar levels. This can lead to peripheral neuropathy—a loss of sensation in the feet. Without the ability to feel pressure, friction, or injury, individuals may not notice cuts, blisters, or wounds, which can worsen without treatment.
These are the complications most specific to podiatry, but it’s important to note that diabetes can also lead to a range of other health issues beyond the feet—such as changes in eyesight, kidney disease, and cardiovascular problems.
What can be done and what should I do ?
People with Type 1 or Type 2 diabetes should monitor their blood sugar levels daily and have regular check-ups with a range of healthcare professionals—including their GP, dietitian, exercise physiologist, and podiatrist. This team-based approach helps create a long-term management plan, along with the education and support needed to stay on top of blood glucose levels and reduce the risk of serious complications like those mentioned earlier.
Anyone diagnosed with diabetes should see a podiatrist at least once a year for an annual diabetic foot check. This assessment includes a series of foot health tests using specialised equipment to detect any vascular or neurological changes in the feet and lower legs. Based on the results, the podiatrist can assign a risk level—low, medium, or high—and recommend an appropriate care plan. If significant changes are detected, this may also signal the need to adjust other aspects of diabetes management, such as diet, physical activity, or medication.
When a person with diabetes—whether Type 1 or Type 2—monitors their blood sugar levels regularly, stays up to date with health appointments, and promptly reports any changes, they greatly improve their chances of avoiding complications and enjoying a long, healthy, and active life.
