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Diabetic Foot Screening

Foot problems are common in people with diabetes. They can happen over time when high blood sugar damages the nerves and blood vessels in the feet. The nerve damage, called diabetic neuropathy, can cause numbness, tingling, pain, or a loss of feeling in your feet.

Image by Ben Hartley

What you should know about Diabetic Foot

What Is Diabetic Foot Ulcer?

A diabetic foot ulcer is a wound or open sore commonly occurring on the bottom of the foot or anywhere on the foot of an individual with diabetes. It is often a chronic complication of diabetes. Diabetic foot ulcers develop due to various factors, primarily nerve damage (neuropathy) and poor blood circulation (vascular issues), that are common in diabetes.

Nerve damage can lead to reduced sensation in the feet, so individuals with diabetes may not notice when they have a cut, blister, or injury, which can then progress into an ulcer if left untreated. Poor blood circulation hinders the body's ability to heal and fight infection. As a result, these ulcers can become infected, causing further complications.

Symptoms Of Diabetic Foot Ulcer

Diabetic foot ulcers are commonly yellow, brown or black in appearance, with swelling and redness around the affected area. Other symptoms of diabetic foot ulcers include:

  • Pain - If the ulcer has progressed to an advanced stage or there is an infection, pain is a significant symptom. However, those with diabetic neuropathy may not be able to feel this pain. 

  • Odour - A diabetic foot ulcer may emit an unpleasant smell, especially if an infection is present. 

  • Warmth or Coolness - The affected area may be unusually warm or cold. Again, this is especially common if the ulcer has become infected. 

  • Numbness or Tingling - Those without diabetic neuropathy may start to feel the symptoms of the condition around the ulcer, including numbness and tingling. 

  • Delayed Healing - Diabetic foot ulcers are difficult to heal and usually will not improve on their own without treatment. 

How Can I Prevent Diabetic Foot Ulcer?

Individuals with diabetes should prioritise preventing foot ulcers. Preventative measures include:

  • Regularly wash feet

  • Completely dry feet after washing 

  • Wear comfortable, clean socks without a band around the ankle

  • Wear proper-fitting shoes 

  • Avoid walking barefoot

  • Avoid wearing heels 

  • Avoid smoking 

  • Inspect feet daily 

  • Maintain a healthy weight 

 

Diabetic foot ulcers are preventable, and daily inspection of the feet can help find sores and wounds before they develop into foot ulcers. Any cuts, blisters or wounds found on the foot should be reported to a doctor as soon as possible.  

What Is A Diabetic Foot Screening? 

A diabetic foot screening is a thorough examination of the feet for diabetes patients, performed by a specialist healthcare professional. These screenings are used to check the health of the feet and identify any risk factors that may lead to foot ulcers. Regular foot screenings are an essential part of diabetes care. 

Who Requires A Diabetic Foot Screening?

Every individual with diabetes at any stage of the disease should receive regular foot screenings, regardless of whether the diabetes is Type 1 or Type 2. These screenings should continue throughout the duration of the condition. 

 

High-risk individuals, such as those with neuropathy, poor circulation, pregnant women, and elderly persons, may have an increased risk of foot ulcers. These individuals will likely receive foot screenings more frequently. 

What Can I Expect During A Diabetic Foot Screening

Diabetic foot screenings are typically painless and non-invasive. The key steps involved in a diabetic foot screening are:

 

1. Medical History Assessment - Your doctor will review your medical and treatment history. This will include any previous foot issues, diabetes duration, medications and relevant health conditions. 

2. Foot Inspection - Next, your doctor will carefully examine your feet, including the ankles, soles and nails. They will look for any injuries, deformities, calluses, blisters, corns, swelling, or changes in the skin.

 

3. Neurological Assessment - Your doctor may test for signs of neuropathy. To do this, they will evaluate your reflexes and foot sensitivity and check for any numbness. 

 

4. Vascular Assessment - During your foot screening, your doctor will also evaluate the blood circulation in your feet. This includes checking your pulse in your feet and examining your skin temperature. 

 

5. Footwear Assessment - Your doctor may ask questions about the type of shoes you wear to determine whether they fit well and do not irritate your feet. 

 

6. Foot Care Plan - Once your doctor has evaluated your feet, they will develop a personalised foot care plan. As well as counselling you in preventative measures, this plan will guide you in your daily foot examinations, appropriate footwear and lifestyle choices. 

 

7. Follow-up - As the final part of your foot screening, your doctor will schedule a date for your next screening or a follow-up visit if more tests need to be completed. 

How Is A Diabetic Foot Ulcer Treated?

Treatments may vary depending on the severity of the foot ulcer, its placement, and any underlying factors. The most common treatments for diabetic foot ulcers are:

 

Dressings - The wound will be cleaned to prevent infection and further irritation, and dressed to promote healing. 

 

Casts and Orthotics - These treatments, including foot casts and shoe insoles, help to offload pressure from the ulcer, allowing it to heal. 

 

Antibiotics - If the ulcer has become infected, antibiotics may be prescribed to fight bacteria at the same time as other treatments. 

 

Debridement - If the ulcer is at an advanced stage, a doctor may perform a surgical debridement to remove dead tissue from the area. 

 

Vein Bypass Surgery - If reduced blood flow is a contributing factor, a vein bypass surgery can redirect blood around blocked arteries to improve circulation, enhance tissue healing, and reduce the risk of serious complications or amputations.
 

Amputation - In severe cases when a diabetic foot ulcer does not respond to other forms of treatment, amputation may be necessary to preserve a patient’s wellbeing. Amputations are commonly viewed by doctors as a last resort. 

Dr Desmond Ooi: Diabetic Foot Screening in Singapore

Dr Desmond Ooi provides diabetic foot screenings, a crucial preventive measure for individuals with diabetes to safeguard their foot health. With his extensive expertise and a dedicated healthcare team, Dr Ooi ensures each patient receives personalised care, addressing their unique needs throughout the screening process. Prioritise your well-being and book an appointment with Dr Desmond Ooi for your diabetic foot screening.

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