Putting the focus on feet

National Diabetes Feet Day is November 12 and Townsville University Hospital (TUH) podiatrists are asking north Queenslanders living with diabetes to put a focus on their feet. 
 
According to Diabetes Feet Australia it is estimated that 510,000 people nationally live with diabetes-related foot disease (DFD) and account for around 47,100 hospital admissions each year.

The Medical Journal of Australia describe it as the least known major health problem in the country.  
 
Leg amputations caused by DFD is disproportionately 10-fold higher in regional areas when compared to metropolitan centres.

First Nations people are 30-times more likely to have diabetes-related lower limb amputations than non-First Nations people. 

Townsville Hospital and Health Service has subsequently invested heavily in podiatry-led high risk foot services to help prevent complications.   
 
Senior podiatrist Christine Hobbs said there are a myriad of reasons why a person living with diabetes could develop DFD. 
 
“It’s most common amongst people with a long history of diabetes, where left unchecked over time complications can develop,” Ms Hobbs said. 
 
“Things like being unable to feel your feet and having poor blood supply can cause foot ulcers which can then lead to the risk of infection and complications like amputation.  
 
“DFD is a big burden on the health system that people aren’t really aware of and even some of our diabetic patients aren’t aware of how big the issue is.” 
 
Ian Colquhoun from Alice River knows all too well how early detection of DFD saved him from further complications and an increased risk of amputation. 
 
Following a visit to his GP, Mr Colquhoun was originally scheduled to get knee surgery but was referred to TUH endocrine high risk foot multidisciplinary team to assess an ulcer on his foot.  
 
“The ulcer developed fairly quickly and luckily my GP got onto it straight away and referred me straight to the hospital,” Mr Colquhoun said.  
 
Ms Hobbs said a range of factors needed to be assessed to determine the severity of Mr Colquhoun’s condition. 
 
“We don’t just look at the patient’s feet, but we also look at how their diabetes is controlled from the food they eat and the blood supply to the area as well,” she said. 
 
“If there is a high HbA1c (blood glucose) level, there’s a higher risk of complications and infections.  
 
“We worked with the diabetes nurse practitioner and endocrinologist to help reduce the HbA1c level and then look at treating the ulcer through a range of different modalities. 
 
“With Ian, we’re slowly transitioning him back into normal footwear and because of the work with the nurse practitioners he’s also had a drop in his HbA1c so overall it’s been a good outcome.  
 
“We’re also looking at finally getting his knee surgery.” 
 
Mr Colquhoun said he is thankful for the treatment and education he has received throughout his patient journey. 
 
“I was lucky to get Christine, who led the team,” he said. 
 
“I wasn’t aware of the range of treatments available, I got some really good advice on how to handle it, and the outcome was great.” 
 
Ms Hobbs says footcare is vital for people living with diabetes and many foot problems are preventable. 
 
“People with diabetes and symptoms like peripheral neuropathy means sometimes these patients can’t even feel their feet so most are not even aware there may be something wrong,” she said. 
 
“A big part of preventing DFD is that daily foot care is important. Look down and look around your feet.  With daily foot checks, annual foot screening, and recommended lifestyle changes, many people with diabetes can prevent DFD.  
 
“If you become aware of any changes in temperature, sensitivity or if your feet show any sign of injury that becomes red or isn’t healing then see a health professional.”