Risk Factors for Diabetic Foot Problems
- Peripheral neuropathy – sensory loss is a major cause of diabetic ulceration
- Peripheral arterial disease/ischaemia – poor blood supply to the foot
- Poor glycaemic control - wound healing and neutrophil function are impaired by hyperglycaemia, good glycaemic management is essential
- Limb ischaemia
- Foot deformities - a recognised risk factor for diabetic foot ulceration
- Ulceration
- Callus
- Infection and/or inflammation
- Gangrene
Charcot arthropathy
Charcot foot is a type of bone deformity that can lead to serious damage and further deformity. It is caused combination of autonomic neuropathy and sensory neuropathy. The bones in the foot become fragile and prone to fracture or dislocate as a reaction to relatively minor forces, including standing and walking.
It is a rare complication of diabetes, but it can lead to serious deformity and ulceration, which subsequently may result in amputation. (NEDFN, 2018; Diabetes UK, 2022)
The signs and symptoms of Charcot foot may include:
- Swelling
- Warmth – the affected foot feels warmer than the other
- Change in foot colour
Nice (2016, 2022) recommends that when examining the feet of a person with diabetes, remove their shoes, socks, bandages and dressings and examine both feet for evidence of the above risk factors. Diabetics who have diabetes for a longer period or manage their diabetes less effectively are more likely to develop foot ulcers.
Smoking, little or no exercise, being overweight, having high cholesterol and/or high blood pressure can all increase the risk of developing a diabetic foot ulcer.
Diabetic feet can be classified into two groups:
- Neuropathic foot with palpable pulses
- Ischaemic foot without pulses and a varying degree of neuropathy (Edmonds & Foster, 2014)