Cogent Evidence
Folarin Babatunde PT PhD MScSEM MScPT BScPT
What Is Diabetes?
Diabetes is a chronic disease in which the body is either unable to produce insulin or properly use the insulin it produces. Insulin is a hormone produced by the pancreas to regulate the amount of glucose (sugar) in the blood. Blood sugar needs to be carefully regulated to ensure that the body functions properly. Too much blood sugar can lead to damage in organs, blood vessels, and nerves. Your body also needs insulin to use sugar for energy.
Unfortunately, one person in Canada is diagnosed with diabetes every 3 minutes. Chances are that diabetes affects you or someone you know.
What Are The Common Symptoms of Diabetes?
Unusual thirst
Frequent urination
Weight change (gain or loss)
Extreme fatigue or lack of energy
Blurry vision
Constant or recurring infections
Slow healing cuts and bruises
Tingling or numbness in the hands or feet
Trouble getting or maintaining an erection
Diabetes ketoacidosis
What Are The Different Types of Diabetes?
There are different types of diabetes depending on your risk factors, namely type 1 diabetes, type 2 diabetes, gestational diabetes and prediabetes.
Types 1 Diabetes
In type 1 diabetes the pancreas do not produce any insulin and generally develops in childhood or adolescence, but can also develop in adulthood. Roughly 10 per cent of people living with diabetes have type 1, insulin-dependent diabetes. People with type 1 need to inject insulin or use an insulin pump to ensure their bodies have adequate insulin.
Type 2 Diabetes
In type 2 diabetes, the body is unable to make enough insulin or fails to properly use the insulin it makes. Type 2 diabetes accounts for 90% of diabetes cases in Canada. People over age 40 years with a parent or sibling with diabetes are at a higher risk.
Gestational Diabetes
Prediabetes
What Is Diabetic Foot?
Foot problems are very common in people with diabetes and can lead to serious complications. In very severe cares, diabetic foot problems may lead to amputation of a toe, foot, part of the leg or both lower extremities. We share basic information about how diabetes affects your feet and what can be done to maintain a healthy feet.
Common foot problems in individuals with diabetes includes the following
Athlete's foot
Fungal infection causing itching, redness and cracking in the foot. Usually occurs when germs enter the cracks in the skin leading to an infection. Fungal infection can also affect the nails causing discoloration (yellowish-brown or opaque), thickening and brittleness.
Calluses
Corns
Bunions
Diabetic foot ulcer
Plantar warts
What Does Daily Foot Care Require?
Daily good foot-care routine and blood sugar control will help keep your feet healthy. Start by putting together a foot-care kit containing nail clippers, nail file, lotion, and a non-breakable hand mirror. Having everything together makes it easier to follow this foot-care routine daily:
Clinical Tip 1: Good diabetic foot care requires washing and drying your feet daily to keep them clean.
Use mild soap and warm water but avoid soaking them for a long time.
Pat your skin gently to thoroughly dry your feet and avoid rubbing them too hard.
Apply a gentle lotion to your heels and soles making sure to wipe off any excess lotion that is not absorbed. Avoid applying lotion to areas between your toes because excess moisture can promote infection.
Sprinkle nonmedicated powder before putting on your socks and shoes to keep feet dry.
Take extra care to moisturize your feet and keep them warm in winter because cold weather and central heating can lead to dry skin. Wear socks to bed during bed times in the cold.
Always clean cuts/scratches with mild soap and water, and cover with a dry dressing suitable for sensitive skin.
Clinical Tip 2: Complete a daily check of your feet everyday.
Thoroughly check your feet and between your toes to make sure there are no cuts, cracks, ingrown toenails, blisters using a handheld mirror by yourself or the help of someone else.
Look carefully at the tops and bottoms of your feet.
Set a specific time each day to do your foot check.
Ensure you check under good lighting to ensure any problem area is spotted.
Check for dry, cracked skin on your feet, toes, and heels.
Look at your feet, toes, and heels for blisters, cuts, scratches, bruises, scrapes, or sores.
Check between your toes for cuts or fungus that might cause athlete’s foot.
Check for redness, increased warmth, or tenderness when you touch an area.
Watch for ingrown toenails, corns, and calluses.
If you notice a blister or sore from your shoes, don't pop it. Put a bandage over it, and wear a different pair of shoes.
Clinical Tip 3: Pay attention to your toenails.
Clinical Tip 4: Exercise with your feet well protected
Clinical Tip 5: Choose the right shoe and socks
What Is The Role of Physiotherapists In Diabetes Care?
Physiotherapists help people with diabetes take part in safe, effective exercise programs which have been shown to improve the lowering of blood sugar levels. Physiotherapists can help you improve the ability to move, perform daily activities, and manage pain promote faster healing of diabetes-related skin problems.
What Does A Session With a Physiotherapist Look Like?
Your physiotherapists will examine your record of blood glucose levels and check your skin for wounds. The session will include a comprehensive assessment of your strength, flexibility, endurance, balance and skin sensation in the feet. Your physiotherapist will use the assessment findings to design a personalized treatment program that addresses any identified problems and specific to your needs and goals.
What Types of Activities Would I Be Doing In Physiotherapy?
Your physiotherapist would guide your through a series of activities based on the treatment program including:
Movement. Your physiotherapist will choose specific activities and treatments to help restore normal movement. These may begin with passive movements where the physiotherapist helps you move your joints gently and later progress to active exercises and stretches that you do yourself.
Strength. Your physiotherapist will teach you the right exercises to safely restore strength in weak areas.
Flexibility. Your physiotherapist will identify tight muscles and help you stretch them gently.
Endurance. Your physiotherapist can teach you exercises to help you regain the energy to return to your normal physical activity level especially if you have been inactive.
Balance and coordination. Your physiotherapist can teach you how to improve your balance and restore your coordination to avoid falls and improve the ability to complete daily living and work-related activities.
Walking ability. Your physiotherapist can teach you how to use a walker or a cane, if needed, to help you balance and walk safely.
Pain levels. Your physiotherapy will prescribe the most effective and safe exercises for you to perform to control and reduce pain. They will also show you how to protect painful areas to reduce sensitivity to diabetic nerve pain (neuropathy).
Blood glucose levels. Your physiotherapist can design a safe, personalized exercise program to help you control and lower your blood sugar.
Healing of sores. Your physiotherapist will check your footwear for proper fit and overall condition and teach you how to perform daily foot and skin checks to avoid blisters and sores.
Home exercise. Your physiotherapist will teach you exercises to perform on your own at home to speed up your recovery based on the exercise program during visits to the clinic.
Ability to perform daily living and work activities. Your physiotherapist will discuss your physical activity goals with you and use them to set recovery goals for you.
FOR MORE INFORMATION
Book an appointment with one of our physiotherapists at Cogent Physical Rehabilitation Center for an assessment and discussion on how physiotherapy can help you find relief from plantar fasciitis.
Sources
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