1. Diabetes and the Foot

2. Introduction Diabetes can cause foot problems. Some of these problems can occur because the nerves and blood vessels supplying your feet are damaged.

3. Pins & Needles Numbess Tingling Burning sensation Cold to touch Dry skin Thickened, crumbly nails Pale in colour Unable to walk long distances without getting pain in the calf muscles High arched foot Prominent balls of feet The feeling in your feet (peripheral neuropathy) The circulation in your feet (Ischaemia) Your foot posture and structure

4. Neuropathy Circulation Foot Posture Diabetic Foot Complications

5. LOW RISK Annual foot screening carried out by the Practice Nurse AT RISK Monitored by the Community Podiatry Service ACTIVE PROBLEM Referred to the Specialist Podiatrist in Diabetes and care is shared with community podiatry What happens in Walsall...

6. NICE Guidelines LOW RISKINCREASED RISKHIGH RISKULCERATED Pulses in the foot are palpable and the patient has sensation in both feet. One or more pulse is not present or the patient can not feel parts of their foot. One or more pulse is not present and the patient can not feel parts of their feet. The same as high risk but the patient will have an active ulceration. Annual review to include foot care education can be completed by the Practice Nurse If the patient has corns or lots of hard skin, problematic toenails they will be referred to the Community Podiatry service The patient will be referred to the Community Podiatry service for assessment and treatment as required. The Specialist Podiatry in Diabetes will see these patients until their ulceration has healed and then care will be shared with Community Podiatry Nice Guidelines (CG10) Type 2 Diabetes Foot Problems: Prevention and management of foot problems, January 2004)

7. Looking after your feet… Check your feet everyday Wash your feet everyday Moisturise your feet everyday Toenails Socks stockings and tights Avoid walking barefoot Check your shoes Badly fitting shoes Minor cuts and blisters Over-the-counter corn remedies

8. Any questions? Thank you for listening