Cape Town:  021 201 1119  

Diabetes Diabetic Foot

 Let food be thy medicine and medicine be thy food - Hippocrates

Could you have diabetes?

Diabetes is increasing in South Africa. Three and a half million South Africans have diabetes & 5 million have pre-diabetes – 78% are undiagnosed.

All diabetic are at risk of amputation.  Seventy – eighty percent of all non-traumatic amputations are performed on diabetic patients.  Almost all of these amputations are avoidable with the right care.
Once a diabetic patient has had an amputation, 25%-68% will have an amputation on the other side within 5 years.

What is the cause of amputations?

Foot ulceration is key.   In fact, over 85% of patients who undergo an amputation started off with a wound.  The best management is Prevention. If a patient has a wound, intense care is required to heal the wound and prevent wound recurrence.

How do ulcers occur in diabetics?

Diabetic Foot Ulcers (DFU) develop as a result of multiple functional physiological changes specific to diabeties including nerve, vascular and immune system problems,  Insert table from brochure

Nerve Problems

The condition of the foot:
The foot becomes dry, fissured, cracked and red.  Nail growth is poor and oil gland function is diminished.  Sweating may also not occur.

This is from the autonomic nerves being affected.

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Foot deformitiies:

These are from the motor nerves being affected

  • Change in the shape of the foot:

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  • Claw toes
  • Widened mid-foot (hallux vulgus)

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  • Dislocation of 1st metatarsal (bone before the big toe)

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These deformities all change the normal pressure loading on the foot:

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Loss of feeling:

This is form the sensory nerves being affected.


A person with diabetes may injure their foot and not realise it initially.  The injury can be from knocking the foot, from ill-fitting shoes, from heater/fire burns or from an unrecognised ingrown toenail.

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Vascular Problems

Wounds require adequate blood supply in order to heal.  Diabetics develop blockages in the blood vessels in the leg so sufficient oxygen and nutrients my not be delivered to a wound which will prevent its healing.

Weak Immune System

Diabetics cannot fight off infection as well as a non-diabetic can. Thus, when there is a wound it is more prone to infection. Infection will spread rapidly in the foot.

If infection is not controlled and blood supply is not optimal, the diabetic is at risk of an amputation.

What should I do if I have a wound?

It is vitally important to seek medical attention as soon as possible.  Almost all (85%) diabetic amputations start with a wound and almost all amputations are preventable. Early intervention is essential.

  • You need to have a full foot assessment.
  • You need an individual diabetic management plan.
  • You need an assessment of cardiovascular risk factors.

diabeticfootDo I need to get my feet checked if I do not have a wound?   

Yes! If you are diabetic, you the best management for this lifelong disease is prevention.

  • You will need to have a full foot assessment.
  • You will benefit from an assessment if all cardiovascular risk factors.
  • You will benefit from an individual management plan.

What is a foot assessment?

A foot assessment includes looking and inspecting the foot for:

  • Presence of Infection
  • Blood Supply
  • Nerve function
  • Foot deformities

In addition, you will benefit from an assessment of all cardiovascular risk factors and an individual management plan.

Where can I get my feet and diabetes checked?

The Vascular Centre will assess whether you are diabetic (and if so, how well controlled your sugar is), your feet and other cardiovascular risk factors.

Your feet are not only the only risk – your kidneys, eyes, heart and brain are all at risk if you have diabetes.

At the vascular Centre you will have a full vascular assessment.

What does a full vascular assessment include?

  • Vascular risk profile
  • Diabetes
  • Blood pressure
  • Cholesterol / lipids
  • Smoking
  • Nutrition / weight
  • Cardiac fitness

What can be done if I have vascular risk factors including diabetes?

Having cardiovascular risk factors means lifelong management of these diseases. These diseases may be exacerbated by lifestyle and diet. None of them are curable. They are all controllable. Everybody is different in terms of their risk factors, lifestyle, stress levels, weight management, exercise regimes and habits. There is not one recipe for everyone. In order to control risk factors, prevent stroke and heart attack and optimise your health, takes time and needs to suit your lifestyle.

You need to understand yourself, your risks and your goals.

How can I control my risk factors and health?

The Vascular Centre will advise you as to what treatment is most suitable for you and create a programme designed especially for you. 

You will be able to take control of your vascular risk factors and lead a healthier, stronger life. 

You willFunction Better. Feel Better. Be Better.

 Call The Vascular Centre for further enquiries or to make an appointment.

Contacts

Room 1521 Christiaan Barnard Hospital, Cape Town, 8001.

  Cape Town Switchboard:  021 201 1119