Putting feet first when caring for patients with diabetes

For patients with diabetes knowing how to take care of their feet and when to seek specialist care can be difficult. A campaign by Diabetes UK aims to raise awareness.

The number of diabetes-related amputations in the UK is at record levels. More than 8,500 procedures were carried out last year, which equates to 23 minor and major amputations a day, or more than 160 a week.

Foot amputations not only devastate lives, they can also be life-limiting: after surgery up to 80% of people with diabetes will die within five years. As well as the enormous human cost, diabetes-related foot problems and amputations are also costly to the NHS; at least £1 in every £140 of NHS spending in England goes towards foot care for people with diabetes.

People with diabetes should have access to specialist foot care teams. Picture: Alamy

But with good healthcare and support, four out of five amputations are preventable, which is why Diabetes UK has launched the Putting Feet First campaign. We want to raise awareness of the dangers of foot problems for people living with diabetes, and help improve the quality of diabetes foot care services. To support this work, there is much that nursing teams working in acute hospitals and care home settings can do to minimise the risk of amputations in people with diabetes.

High risks

First it’s essential that all staff working with older people who have diabetes – particularly those in care homes or hospitals – recognise that they are likely to be at high risk of developing a serious foot problem that can lead to an amputation.

People with diabetes are at much greater risk of developing problems with their feet because of the damage that raised blood sugars can cause to sensation and circulation. Loss of sensation can lead to foot injuries, blisters and cuts going unnoticed and, if left untreated, these can result in foot ulcers, infections and eventually even amputation.

Whose responsibility?

That’s why it’s so important that all people with diabetes – and particularly those with high-risk feet – get a formal foot check with their GP every year, and have access to specialist diabetes foot care teams and community diabetes podiatrists, who can identify problems and treat them quickly. Foot problems in people with diabetes, such as infections or ulcers, can deteriorate fast.

It is also important that people with diabetes know how to look after their feet themselves and check them daily. Those who live in care homes, especially people who are frail or have dementia, may not be able to take responsibility for their diabetes management, so will need support from nursing staff to care for their feet.

What to look for and when to seek specialist attention

When checking a person’s feet nurses should check the temperature and condition of the skin and toenails. They should be on the lookout for changes in the shape or colour. Danger signs include discolouration, pain and a build-up of hard skin. If any of these signs are present then nurses should seek urgent specialist attention. It’s vital that any change, no matter how small, is assessed by an appropriate healthcare professional.

Video guide campaign

Being aware of the early signs of foot problems in people with diabetes can significantly reduce the risk of an amputation. But it can be hard to know what action to take and when, so as part of its campaign, Diabetes UK has produced a video guide to help people with diabetes, and their carers, take good care of their feet.

To view the video and for more information about the campaign visit the website

About the author

Dan Howarth is head of care at Diabetes UK

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