SHARES
We often hear people with diabetics requiring amputation of the leg or foot. We asked Dr Helen Crawford, podiatrist and osteopath at Physionique, what can be done to maintain better diabetic foot care and to avoid such dire consequences for diabetic foot conditions.
GetDoc: How often do you see diabetics for foot conditions at Physionique?
Dr Helen Crawford, podiatrist at Physionique
Dr Helen: At Physionique, we do more preventative work, so more screening and advice on footcare and footwear for diabetics. We therefore don’t tend to see so many diabetic foot conditions such as ulcers and Charcot foot. We do treat many patients who have diabetes preventively for routine nail care and corns and callus. However, these are not specifically diabetic foot conditions.
GetDoc: How does diabetes affect the feet?
Dr Helen: Diabetes, if not well-controlled, can affect the feet by damaging the nerves and blood vessels that supply the feet. This makes them more susceptible to injury and slower to heal due to reduced blood supply.
GetDoc: What are the types of diabetic foot problems? What are their symptoms and consequences?
Dr Helen: The most common diabetic foot problem is ulceration. Ulceration occurs over high pressure areas and often starts with corns and callus, which is why regular podiatric treatment to debride these lesions is important in prevention. The consequences of ulceration can be catastrophic as it can lead to amputation. One less common problem is Charcot foot. This can occur in people with neuropathy (loss of sensation) and leads to deformity of the bones in the foot which long term is more likely to cause ulceration.
GetDoc: What are the treatment options for diabetic foot problems?
Dr Helen: There is an awful lot of different treatments for ulcers, ranging from offloading weight, hyperbaric oxygen, many dressings, maggots to name a few. And as mentioned, at Physionique, we conduct preventative treatment for diabetics in nail care, corn, and callus.
GetDoc: Is it possible to prevent diabetes from affecting the feet?
Dr Helen: Good blood sugar control is the key to prevention of diabetic foot problems. After that, yearly diabetic foot checkups by a podiatrist or endocrine doctor as well as properly fitted footwear in approved styles (lace, buckle, fastening) to prevent blisters, corns and callus. Correct toenail cutting and daily foot checks are also important.
GetDoc: How frequent must diabetic patients get screened/follow up?
Dr Helen: This can depend on what level of risk you are for developing foot complications. Your podiatrist or doctor will determine this. High-risk patients should have check-ups more frequently, for instance, every 3-4 months, moderate risk patients every 6-9 months, and low-risk patients yearly. Follow-up for ulcers can be as often as once or twice a week.
GetDoc: Any other interesting things to note about diabetes and podiatry care?
Dr Helen: I haven’t got the studies or the actual figures but there are clinical studies that show that having a podiatrist on the diabetes team can significantly reduce the number of diabetic amputations. It is the reason that initially podiatrists were brought into Singapore from overseas.
Regular screening is essential to manage diabetic foot care and prevent any (severe) complications to the lower limbs resulting from diabetes. Start prevention early with Physionique. Schedule an appointment with Dr Helen Crawford on GetDoc today.
by waiyee
Film junkie. Matcha drinker. Dog lady. Will write for food. View all articles by waiyee.
