Type 1 – which often starts in childhood, or after a shock. The pancreas, which normally produces insulin, stops producing any insulin at all. Insulin is required to enable sugar to move from the blood stream to our muscles, cells and the brain. For these patients insulin is the only treatment and must be given as an injection for life.
- Nerve Damage (peripheral neuropathy) – having a high level of sugar in the blood can damage the longest nerves, especially those which reach down to our feet, causing them to be unresponsive. Nerve damage is generally irreversible. Loss of feeling in the feet can increase the risk of a diabetic foot ulcer. This is because impaired sensation does not give a normal warning of pain eg if there is a stone in your shoe, if the bath is too hot or if you knock your foot when walking.
- Blood vessel damage (Peripheral vascular disease) – After prolonged periods of high blood sugar, the peripheral blood vessels can become furred and narrower, thus restricting blood flow to the small capillaries in our body – in particular the eyes, kidneys and feet. The higher blood sugar also makes the blood more viscous-or thick, so that it is less able to flow into the small capillaries. This has a specific effect on wound healing, such that nutrients and essential wound healing components of the blood cannot easily get to the wound to heal it.
- Lowered immunity – this puts diabetic patients at higher risk of bacterial, fungal and viral infections.
At the Forest Foot and Health Clinic we provide the following specific services for patients with diabetes:
- Annual diabetic checks including nerve and blood flow testing
- Letters to GP to inform them of results
- General foot care reviews
- Self-care advice, including advice on diet
- Early referrals to multi-disciplinary teams for further care if necessary