What is it? The "foot in diabetes" is a term used to describe a range of common, often severe, foot complications that affect people living with type 1 or type 2 diabetes. It is a critical aspect of diabetic health because diabetes can directly affect the feet in two main ways, significantly increasing the risk of serious complications, including ulcers, infection, and, in severe cases, amputation.

• 1. Peripheral Neuropathy (Nerve Damage): High blood sugar levels can damage the tiny nerves in the feet over time. This leads to a loss of sensation. You might not feel a stone in your shoe, a blister, a cut, or even temperature changes, which means minor injuries can go unnoticed and escalate quickly.
• 2. Peripheral Arterial Disease (PAD - Poor Circulation): Diabetes can cause the blood vessels in the legs and feet to narrow and harden (atherosclerosis), reducing blood flow. Good circulation is essential for tissue health and healing, so poor circulation slows down the healing process and increases the risk of infection and tissue death (gangrene).

In the UK, diabetic foot complications are a leading cause of hospital admissions. Therefore, expert podiatric care is not optional but an essential component of the diabetic management plan for all patients.

What are the symptoms?

• Neuropathy Symptoms: Numbness, tingling, a burning sensation ("pins and needles"), or even sharp, shooting pains in the feet, often worse at night. Your feet might feel 'asleep' or cold even when they are warm.
• Circulation Symptoms: Cold feet, pale or 'bluish' discolouration of the skin, pain in the calves when walking (claudication) that improves with rest, and slow-healing cuts or sores.
• Skin and Nail Changes: Drier skin prone to cracking, especially on the heels, is common due to reduced sweat production. Corns and calluses often form under pressure points and can hide underlying ulcers. Nails can become thickened or infected.
• Foot Shape Changes: Muscles can weaken, causing the small bones to shift, leading to deformities like hammer toes or claw toes, which create new pressure points.

What causes it? The sole cause of diabetic foot complications is the cumulative effect of poorly controlled blood sugar levels over time. Maintaining good blood glucose, blood pressure, and cholesterol levels is critical to prevention. Other risk factors include a long duration of diabetes, being overweight, smoking, and previous foot complications.

What are the treatment options? It is vital to never treat corns, calluses, or ingrown toenails yourself, and to check your feet daily. Professional podiatry management focuses on preventing severe complications through meticulous, preventative care:

• Annual Diabetic Foot Assessment: A comprehensive, multi-point check that is the gold standard of care. This includes using a Doppler (an ultrasound scan) to check the pulses in your feet, and a Monofilament test to precisely assess your nerve sensation. We then provide a full 'risk status' report for you and your GP.
• Preventative Skin and Nail Care: We paintessly remove corns and calluses and safely cut thickened or problematic nails. This reduces pressure and eliminates areas where dangerous ulcers can form under the hard skin.
• Specialist Footwear & Orthotics: Designed from 3D scans, bespoke insoles "offload" high-pressure areas and protect fragile skin from irritation. We can also provide specialist, extra-depth, or customized footwear.
• Education and Guidance: We teach you exactly how to examine your feet daily at home, what specific signs to look for, and when to seek urgent care.
• Wound Management: For non-healing sores or ulcers, we provide advanced dressing techniques and collaborate closely with specialized NHS diabetic foot clinics if required.