Why Should Someone Living with Diabetes See a Podiatrist?

When someone is diagnosed with diabetes, they are often bombarded with information. This information is often delivered in complicated, technical language and can be delivered by many different health professionals over many different appointments. 

In fact, it’s not uncommon for someone to have been recently diagnosed with diabetes to be recommended to consult with an endocrinologist (diabetes specialist), diabetes educator nurse, dietitian, exercise physiologist and a podiatrist. This can be overwhelming! 

One question that often arises at this point is: Why do I need to see a podiatrist for diabetes? 

The simple answer is this: Diabetes can cause damage to the nerves and arteries in the body. This damage often occurs in the smaller nerves and longer nerves first, and also in the smaller arteries and longer arteries first. 

The smallest nerves and arteries that are commonly affected by diabetes are in the eyes, kidneys and toes. 

The longest nerves and arteries that are commonly affected by diabetes are in the feet and toes. 

A regular nerve and artery assessment of your feet can provide you with valuable information about your nerve and artery health. This may provide you with peace of mind, or may help you understand your health and have a plan to prevent further complications.

The most important thing about a diabetes related neurovascular assessment is that an understanding of your health is established, recorded and then compared at the next assessment. If at any stage in the future, there is a change detected, we can take a proactive approach and address any concerns well before signs of complications have arisen.  

What are the early signs of nerve and artery damage in the feet? 

The important thing to understand about diabetes is that there are often no early signs of long term complications. This means that health changes can go unnoticed until a time when visible and physical signs have arisen and when irreversible damage has already occurred. 

What are the lower leg and foot complications of diabetes? 

Nerve and artery pathology can lead to a range of problems that are often a little confronting to hear the first time you may learn of them. Complications are often life changing, scary to think about and how they occur is often poorly understood by people living with diabetes. The important thing to understand about diabetes complications is that they are often very preventable – with early detection, which is the importance of a regular diabetes related foot assessment

Nerve complications can include: 

  • Numbness (Loss of feeling in the toes, feet and lower legs)
  • Coldness of the legs
  • A tingling, pins and needles sensation in the feet
  • Burning sensations in the legs and feet, usually more noticeable in bed at night
  • Cuts which are slow to heal that may develop into foot ulcerations

Artery complications can include: 

  • Aching/ leg cramps after walking particular distances or up stairs
  • Pain in the feet, even at rest (often in the early hours of the morning)
  • Feet feeling cold
  • Feet looking a reddish-blue colour
  • Cuts which are slow to heal that may develop into foot ulcerations 

Often the most talked about nerve / artery complication of diabetes is amputation of a toe, foot or leg. This usually occurs in cases of very advanced and poorly managed diabetes. Often, there have been many warning signs that have either gone unnoticed or have for some reason been unable to be addressed. 

How can I prevent complications of diabetes? 

The best way to manage diabetes  is to have a better understanding of diabetes and your general health. It’s quite simple. People don’t often need the complicated, technical language – they can do very well with a basic understanding of diabetes, a basic understanding of their nerve and artery health and how they can prevent complications and encourage good health

Generally speaking, complications of diabetes are related very closely with blood glucose levels. The higher the blood glucose levels rise above a normal reading, the higher the risk of a nerve or artery complication. 

It is recommended that if you have diabetes, you have an understanding of what a normal or recommended blood glucose range is for you. If you are unsure of this, you can consult with your doctor. 

Sometimes, specific information and advice is needed for specific diabetes complications.

How often should I have a diabetes related nerve and artery test with a podiatrist? 

As per Diabetes Australia, an assessment with a podiatrist it is recommended: 

  • At least a once per year for people without a history of diabetes related complications. 
  • Every 3-6 months for people with a history of diabetes related complications. 

Can I seek a medicare rebate for my diabetes foot assessment? 

YES you can!

The diagnosis of diabetes will meet the conditions for a Medicare rebate for podiatry under the EPC Program, which is the Enhanced Primary Care Program. Sometimes, doctors or practitioners may refer to this as a Team Care Arrangement (TCA), or a general practitioner management plan (GPMP). 

You need to have the appropriate referral form from your GP, who needs to allocate a number of visits on this plan to your podiatry clinic.