What is diabetes?

Diabetes mellitus, or simply diabetes, is a group of metabolic diseases where a person has high blood sugar, either because the pancreas does not produce enough insulin or because cells do not respond to the insulin that is produced. This high blood sugar produces the classical symptoms of polyuria (frequent urination), polydipsia (increased thirst) and polyphagia (increased hunger).
There are three main types of diabetes:
Type one: This is caused by the body’s failure to produce insulin, and currently requires the person to inject insulin or wear an insulin pump. This type of diabetes was previously referred to as ‘insulin-dependent diabetes mellitus’ or ‘juvenile diabetes’.
Type two: This is caused by insulin resistance, a condition in which cells fail to use insulin properly, sometimes combined with a complete insulin deficiency. This type of diabetes was previously referred to as non-insulin dependent diabetes mellitus or ‘adult-onset diabetes’.
The third main type of diabetes, gestational diabetes, occurs when pregnant women without a previous diagnosis of diabetes develop a high blood glucose level. It may precede development of Type 2 diabetes.
Untreated, diabetes can cause many complications. Acute complications include diabetic ketoacidosis and nonketotic hyperosmolar coma. Serious long-term complications include cardiovascular disease, chronic renal failure, and diabetic retinopathy (retinal damage). Adequate treatment of diabetes is therefore very important, as well as blood pressure control and lifestyle factors such as stopping smoking and maintaining a healthy body weight.

How can diabetes affect my health and my feet?

Diabetes poses a serious risk for foot disease. In fact, about 30 percent of people with diabetes who are older than 40 develop medical problems with their feet. The damaged nerves and poor blood circulation that often accompany elevated blood sugar ensure that there is no such thing as a minor cut, scrape, bump, or bruise on the foot when you have diabetes.
While blood-sugar problems can create a dizzying range of hard-to-treat complications, lower-limb diseases that are not properly treated can deteriorate so quickly and so badly that doctors have no other choice but to eliminate the problem altogether – people with diabetes account for 60 percent of all lower-limb amputations. In fact, a patient with diabetes is 10 to 30 times more likely to have a lower limb amputated than a person without the disease.

What is ‘diabetic foot syndrome (DFS)’?

Diabetic foot syndrome, or diabetic foot, is when a constellation of pathologic changes affect the lower extremity (feet), often leading to amputation and/or death due to complications. The common initial lesion leading to amputation is a nonhealing skin ulcer, induced by regional pressure, pathogenically linked to sensory neuropathy, ischemia and infection.

What is a foot ulcer?

A foot ulcer is where an area of skin has broken down and you can see the underlying tissue. Most skin ulcers occur on the lower legs or feet. The skin normally heals quickly if it is cut. However, in some people with diabetes the skin on the feet does not heal very well and is prone to developing an ulcer. This can even occur after a mild injury such as stepping on a small stone with bare feet.
Infection often occurs around an ulcer but can also occur as an infection in the skin (cellulitis), the bone (osteomyelitis), or a general infection in your blood (sepsis). The deformity of diabetes is also called ‘charcot arthropathy’, a medical term that mean changes in the joints due to nerve problems. Common foot deformities in diabetes include:

– bony prominences
– claw toes
– flatfoot
– complications after other injuries

Does diabetes lead to poor circulation in the feet?

If you have diabetes you have an increased risk of developing a narrowing of the arteries (peripheral vascular disease). This is caused by fatty deposits, called atheroma, which build up on the inside lining of arteries (sometimes called ‘furring’ of the arteries) and can reduce the blood flow to various parts of the body. Skin with a poor blood supply does not heal as well as normal and is more likely to be damaged. Therefore, if you get a minor cut or injury, it may take longer to heal and could become worse and develop into an ulcer, especially if you also have reduced sensation in the feet and cannot feel the wound.

How do I care for my “diabetic foot”?

Research has shown that people with diabetes who take good care of their feet and protect them from injury are much less likely to develop foot ulcers.

Tips for good foot care:

Look carefully at your feet each day, especially between the toes. If you cannot do this yourself, you should ask someone else to do this for you. Looking is particularly important if you have reduced sensation in your feet, as you may not notice anything wrong at first until you look. If you see anything new (such as a cut, bruise, blister, redness or bleeding) and don’t know what to do, see your doctor or podiatrist (chiropodist).

Do not attempt to deal with corns, calluses, verrucas or other foot problems yourself. They should be treated by a health professional such as a podiatrist. Importantly, do not use chemicals or acid plasters to remove corns.

Use a moisturising oil or cream for dry skin to prevent cracking. However, do not apply it between the toes as this can cause the skin to become too moist which can lead to an infection developing.
Look out for athlete’s foot (a common minor skin infection). This causes flaky skin and cracks between the toes which can become sore and infected. If you get athlete’s foot it should be treated with an antifungal cream.

Cut your nails by following the shape of the end of your toe, but do not cut down the sides of the nails or cut them too short, or use anything sharp to clean down the sides of the nails – this may cause damage or lead to an ingrown toenail.
Wash your feet regularly and dry them carefully, especially between the toes.
Do not walk barefoot, even at home. You may tread on something sharp and damage your skin.
Always wear socks with shoes or other footwear.
Avoid foot burns – always check the bath temperature with your hand before stepping in, and do not using hot water bottles, electric blankets or foot spas.

What causes smelly feet, or bromodosis?

If sweat stays on the body it can encourage bacteria and fungi to grow (which can lead to athlete’s foot). The smell is caused by the bacteria in the sweat.
Bromodosis (smelly feet) can also be caused by hyperhidrosis, a condition where the skin sweats excessively. Hyperhidrosis is often most common in teenagers and pregnant women, whose hormones are changing.

What does Sanitized® mean?

This is an antibacterial, antifungal and anti-odour finish under the license of Swiss company Sanitized®. The license can only be granted to a producer who guarantees the highest quality technological processes. Each type of sock with the properties described above is marked with the Sanitized® logo.

What are silver yarns?

Special yarns containing silver ions are often used in new generation medical socks and sports socks. Silver ions act as a natural deodorant and reduce the microbe growth in the fabric and therefore prevent microbe growth on the skin beyond the natural level, ensuring a long-lasting antimicrobial and anti-odour effect.