• Diabetic Foot is the result of poor blood sugar control resulting in the impairment of wound healing, nerve damage, blood vessel damage, other complications. The effect is that the individual with diabetes is more likely to have ulceration and foot deformities which may lead to eventual amputation.
  • To prevent diabetic feet, it is extremely important that individuals with diabetes get their feet checked at each visit with the physician
  • Many Antiguan and Barbudans work in jobs where they are required to be on their feet. In addition, many walk barefoot for extended periods. This can increase the likelihood of foot- related complications.
    • Individuals with diabetes should also be comfortable with checking and caring for their own feet. This helps to prevent complications.
    • The below poster provides a useful overview:
    Remember, the complications associated with diabetes can be debilitating. Diabetes is the leading cause of limb amputation in Antigua and Barbuda. Take note:
Early signs of Diabetic Feet
  • Swelling: often the first sign of diabetic feet
  • Redness: May indicate infection or irritation. If the area is warm or has red streaks, see your family physician
  • Pain and burning: this is the beginning of what is known as neuropathy. Neuropathy is the damage of the nerves of the feet and can be quite painful. The sensations described include: intense burning, pins and needles, stabbing/shooting pains, freezing, hypersensitivity. Creams, oral medications, and lifestyle changes can help manage these sensations. A good pair of shoes is also important.
  • If ulcers occur, they are usually superficial in nature. Regardless, ulcers should always be reported to members of your healthcare team.
It is important to ensure that you have shoes which properly fit your feet.  
Mid-stages of Diabetic Feet
  • Tingling: As neuropathy or nerve damage progresses, the pain will begin to subside. The feet will become less sensitive to sensation and a characteristic tingling or numbness will occur.
  • Changes to the skin: normal sweat and oil production becomes impaired. The feet dry out more quickly. Calluses and corns
  • Reduced circulation to the foot
  • Nail deformities (thickening or loss of nail)
  • Wound healing impaired: Blood vessels in the feet become leaky and infections become more frequent
  • Foot ulcers are more severe in nature and more likely to be infected (as noted above)
Late Stages of Diabetic Feet
  • Loss of sensation in the feet: this is dangerous as this is what leads to development of ulcers and infections. Individuals who have lost sensation in their feet cannot feel objects like small pebbles and stones as they rub against the feet.
  • Charcot’s Joint: After loss of sensation, the foot muscles may begin to lose their ability to balance the joints properly. This can be extremely debilitating and a non-weight bearing cast may be necessary
    Ulcer formation becomes more prevalent and serious. Nerve damage and poor blood circulation ulcers may not be felt, even when infected. Gangrene and necrosis can occur (which require amputation as treatment).
Excellent Resources
  • American Diabetes Association - http://www.diabetes.org/living-with- diabetes/complications/foot- complications/
  • American Podiatric Medical Association - http://www.apma.org/Learn/FootHealth.cfm?ItemNumber=981
  • Diabetes Canada - https://www.diabetes.ca/diabetes-and- you/healthy-living- resources/foot-care/signs- of-foot- problems
  • International Diabetes Federation Foot Screening Pocket Chart - https://www.idf.org/component/attachments/attachments.html?id=1176&task=download
  • Novo Nordisk Changing Life Program - https://www.novonordisk.com/about-novo- nordisk/changing-diabetes/changing-diabetes- initiatives.html
  • Wound Care Centres - https://www.woundcarecenters.org/article/wound-types/diabetic- wounds
Excellent Case Study The Dermatologist - http://www.the-dermatologist.com/content/saving- diabetic-patients- foot

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