Finding the chase and cutting to it

I woke up on Wednesday morning and groaned at the latest “diabetes” story on the radio 4: Diabetes amputation rates show huge regional variation.

Rather than teach the newly diagnosed that actually, checking your feet regularly (and if you have a diagnosis of neuropathy, daily) is an effective way  of picking up infections that may lead to amputation, Diabetes UK wish to ensure diabetic feet are checked annually.

After all such infections only occur just before our hospital visits.

My experience with topical infection has shown that seeking treatment for subcutaneous infections meets with complete disinterest from doctors who very reluctantly will prescribe the appropriate level of antibiotics.  I have had a skin cream, much like E45, prescribed in these instances to end up three days later in hospital having an abscess drained!

GPs need to understand that diabetics, especially with severe nerve damage, need access to antibiotics.  Much like a human missing a spleen, our bodies do not fight infections easily and time is of the essence.

We need to understand, that we need to look after this.  I met a soldier once who examined his feet and legs daily to ensure his most precious equipment worked well: he saw this as his responsibility.

As a diabetic, we have the responsibility to look after ourselves.  We need to check our feet regularly ourselves or ask a loved one to help.

We also need the medical profession to understand the risks we carry.  Antibiotics, even given out of hours, are much cheaper than operations and prosthetics.

How to check your feet

1. Check the skin for tears and abrasions (cuts), punctures and splinters (large and small).   You are checking that the skin is intact.
2. Have you any new blisters or corns? – remember them, that’s where you’ll start your check tomorrow!
3. Are there any red or hot patches?  When you have a skin infection, you will often have a localised rise in temperature round the primary site.  If you can’t tell, some adults have difficulty detecting differences in temperature, ask someone to check for you.  If you have a “hot area” and have been wearing shoes and socks – remove them for 30 minutes and recheck.  If it’s still hot, seek medical attention.