Put your feet first on World Diabetes Day

Mathew King, pathway lead podiatrist for Solent NHS Trust with John Kenna, who has type two diabetes. ''Picture: Sarah Standing (133118-7065)
Mathew King, pathway lead podiatrist for Solent NHS Trust with John Kenna, who has type two diabetes. ''Picture: Sarah Standing (133118-7065)

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Within 24 hours of a small cut, an infection looking like a cauliflower had sprouted from John Kenna’s toe.

The 66-year-old had no idea he was a type-two diabetic, until an ulcer appeared on his big toe on his right foot.

Mr Kenna, of Manor Road, Fratton, went to see his GP about the infection, where he was diagnosed with type-two diabetes.

On World Diabetes Day, Mr Kenna is urging people to put their feet first and ensure they look after them.

He says: ‘I wish I had gone to see my GP earlier, but I hadn’t been since I was at school.

‘Both my brother and my father had toes amputated because of diabetes, but I didn’t spot any signs.’

Solent NHS Trust runs a podiatry service in Portsmouth, including clinics at the Turner Centre, in St James’ Hospital, in Locksway Road, Milton.

Mathew King is a pathway lead podiatrist, and explains why diabetes can lead to amputation of the lower limbs.

He says: ‘With diabetes, people can lose the feeling in their feet.

‘Diabetes affects the nerves, which leads to a loss of sensation, so people cannot feel pain.

‘This means they don’t know if they have done any damage.

‘The amount of sugar in your blood is affected by diabetes, and can either be really high, low, or go between the two.

‘That can cause problems with blood flow, and cause loss of feeling.

‘It means someone would not feel if they cut or graze their feet.

‘An infection would feed off the sugar and cause problems very quickly.’

It’s something Mr Kenna, a retired plasterer, has had experience with twice.

He was diagnosed with diabetes four-and-a-half-years ago.

‘I still don’t know what caused the initial infection,’ adds Mr Kenna.

‘I had tripped on the pavement a few days earlier, so it may have been that.

‘This time I think I nicked myself when cutting my toenails.

‘Within hours the second toe on my right foot became infected, and my son James, took me to see the team.

‘He is brilliant and helps me with my dressings and driving me to my appointments.’

People with diabetes will always be prone to getting infections, that could turn into ulcers very quickly, if left untreated.

Graham Bowen, head of podiatry services at Solent NHS Trust, says every person with diabetes should have a yearly foot examination by their GP.

He says: ‘These amputations can be prevented by people knowing how to take care of their feet correctly and receiving the right care at the right time by the right people.

‘If you have or develop a foot ulcer, don’t neglect it – seek prompt help and advice from the podiatry service, your practice nurse or your GP.

‘Yearly diabetic foot assessments are extremely important and shows your foot risk level.

‘It’s important this is done, otherwise you run a risk of developing a foot complication that could go undetected and could result in the loss of a lower limb, which could have been avoided.

‘On the day we mark World Diabetes Day, it is only right that we remind everyone in the city to look after their feet.’

The team gets an additional 40 to 50 referrals a day, and once you’re seen by the team, you’re a patient for life.

About 85 per cent of new referrals come from healthcare professionals, such as doctors and nurses, while the other 15 per cent is through self-referral.

Portsmouth has one of the highest foot amputation rates in the country – but the figure is coming down.

Between 2011/2012, there were 48 major amputations, this fell to 36 in 2012/2013.

It is advised people go to see their GP if they have any concerns, who in turn will do the following tests:

n Neuropathy testing.

The examiner will test for any numbness in the feet.

Sensation will be checked with either gentle pressure to the underside of your toes and the ball of your foot using either finger touch or a fine plastic strand called a monofilament or vibration using a tuning fork.

n Circulation testing.

The examiner will feel the pulses you have in your feet and legs to check how well the blood is circulating to your feet. Walking is the best exercise for your circulation.

n Foot inspection.

Checks for changes in their shape. Your footwear will be checked to make sure it will not be the cause of any foot problems.

WORLD Diabetes Day was jointly introduced by two organisations.

It was brought in by the World Health Organisation, and the International Diabetes Federation (IDF).

The IDF is an umbrella organisation of more than 200 national diabetes associations, in more than 160 countries.

It aims to influence policy, increase public awareness and encourage health improvement.

The global diabetes awareness campaign was introduced amid concern over an escalating diabetes epidemic.

Each year, World Diabetes Day, which is co-ordinated by IDF, carries a particular theme, and between 2009 and 2013, the theme has been ‘education and prevention’.

The awareness day falls on November 14, as it’s a significant date in the diabetes calender.

It marks the birthday of Frederick Banting – the man who in 1922 co-discovered insulin alongside Charles Best.

World Diabetes Day is internationally recognised and is now an official United Nations Day.

To find out more information, visit idf.org/worlddiabetesday

ARE you aware of your foot risk?

People with diabetes are more prone to getting foot infections, and should have a yearly examination carried out by their GP.

The check will put you in one of four categories – low risk; increased risk; high risk or ulcerated.

Solent NHS Trust’s podiatry service said that if your score is at low risk, you will be given general footcare advice until your next annual foot review.

If you are at increased risk, high risk or ulcerated, you will be referred to see a member of the team.

Steps you can take to prevent problems happening include:

Give up smoking.

Keep your blood glucose, blood pressure and cholesterol levels as near normal as possible.

Eat a healthy diet which is low in fat, sugar and salt, and high in fruit and vegetables.

Make sure your feet are not exposed to extremes of heat or cold.

Take regular physical activity.

Make sure your socks and shoes are comfortable and fit well.

Check your feet daily, including in between your toes.

Attend your review.