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DIABETES. Diabetes is a metabolic disorder characterised by a relative or absolute deficiency of insulin affecting the metabolism of protein, fat, carbohydrate, water and electrolytes. These disturbances lead to progressive and sometimes irreversible functional and structural changes in all organs of the body. Diabetes is probably the most damaging disease which a patient can encounter with regards to their feet. Diabetes comes in two basic types: Type 1. and Type 2. Type 1 is usually associated with juvenile diabetes and is usually a hereditary type of disease. Type 2, is principally a disease of the middle aged and elderly, 80% of cases presenting after the age of 50 and is commonly referred to as adult onset diabetes. Depending on the individuals insulin levels in the blood, diabetes can be controlled with diet and medications or in severe cases daily injections of insulin. The two main complications which can effect diabetic's feet are poor circulation and peripheral neuropathy (loss of feeling and disturbed sensation). 1. Poor circulation results in intermittent claudication (pain in the calf muscles during walking) as well as leg cramps during the night. 2. Peripheral neuropathy is a frequent complication and may go unnoticed by the patient. If the patient is unaware of peripheral neuropathy the feet and toes can become traumatised and in the presence of poor circulation ulceration and gangrene can occur. It is important that a patient with a foot ulcer consult their podiatrist or family doctor. In diabetes, neuropathy combined with poor circulation are the main complications that lead to loss of a limb. To reduce these complications many tests are employed to maintain diabetic good health, including blood tests, MRI's, x-rays, and constant supervision. In addition to this good diabetic hygiene, skin care and regular treatment of any corns / callous by a State Registered Chiropodist / Podiatrist will help to minimise the potential complications. If you suspect that you may have a diabetic ulcer, immediate medical attention is necessary.
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