Ask a Podiatrist: How to care for your feet as a diabetic

Mopani Pharmacy had a chat with local podiatrist, Hannes Fuhri on the details of diabetic foot care.

Hannes Fuhri, Podiatrist

What is a podiatrist?

“Like physio-therapists and opticians, I studied directly after school to become a podiatrist – it is a 4-year course. I treat all lower-limb problems, conditions and injuries. To become a podiatrist, you do not have to study medicine and then specialise after that, like orthopaedic doctors do,” he explained, adding, “you also don’t have to call me by any title, just call me Hannes!”

How often do you deal with diabetic patients?

“I see diabetic patients daily. Some at early or non-problematic stages and some at advanced stages, when there could be some symptoms already.”

Does this illness favour any age groups?

“Diabetes can affect all of us at any stage of life, but usually we see more problems as we get older. If younger diabetics don’t look after themselves, then they will also show more symptoms, earlier.”

What symptoms are the most common?

“Most diabetics will experience burning and pins and needles in the feet and lower limbs. Some, who accidentally wound themselves, will have trouble healing if their diabetes, or more commonly referred to as blood sugar or blood glucose is out of control.”

How does the cause lead to the effect?

“For ideal functioning of the eyes, kidneys, feet, etc., the blood sugar level should be between 5 – 7 m.mol/L. If these levels fluctuate up or down too much, too frequently, it causes an imbalance. This can cause damage to various organs and parts of the body”, he explained.

“The nerves are very sensitive to these fluctuations and when they are damaged, you can experience a variety of symptoms like pins and needles, numbness, burning and stabbing pains –called peripheral neuropathy. This will first be noticed in your extremities, such as your hands and feet, due to narrowing of smaller arteries and capillaries. If the fluctuations continue, complete loss of sensation in the hands and feet may occur”, he continued.

“This is dangerous. Should your shoe chafe your heel, and you don’t notice, over time, the reddening skin will become raw, and then become an open wound. Due to the loss of sensation, you won’t think to treat it, and this poses a risk for infection”, he explained.

“In the end, a poor blood supply leads to slower healing of wounds, which can turn into infection and gangrene, and ultimately, partial to full amputation of the extremity”, he warned.

Are these ailments or symptoms preventable or reversible?

“Yes, we have a very large number of diabetics world-wide that show no symptoms and live a normal life if they stick to strict blood sugar control, some form of exercise, strict diet control and preventative foot-care regimes are followed”, he said.

“If help is sought early enough and the blood sugar levels are controlled very strictly, then improvement and reversal to an extent can be achieved”, he added.

When should you seek help?

“You should see someone as soon as you experience the slightest symptoms, but annual check-ups are very successful in educating and prevention of the complications associated with being a diabetic”, said Hannes.

“You can visit your doctor or a Sister at Mopani for advice, and you don’t need a referral to see a podiatrist either, you can just book an appointment. If you are not getting relief from one, ask for a second opinion at another, but do not wait too long to get the help you need”, he concluded.

What should diabetics look out for in terms of this condition?

“Daily preventative foot- and shoe checks for any signs of loss of blood supply, loss of sensation, un-noticed wounds are important. Even the small scratches should be antiseptically dressed immediately”, he recommends.

What are you asked most often, and what do you answer?

How do I sleep with this constant burning / stabbing pains in my feet?  Controlling your blood sugar and taking care of your feet is a long, on-going process that will improve on the symptoms, but if you waited too long you may not have 100% improvement.  However, it’s never too late to start looking after yourself. Therefore make sure you take early and preventative measures to reduce your risk of developing symptoms.”

Where can we find you?

“My practice is in Nelspruit, at 11 Ehmke street. You can book an appointment on 013 752 3972, 082 924 5621 or hannesfoot@vox.co.za” he concluded.

PS

Read more: Taking care of Diabetes at Mopani Pharmacy

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