Diabetes and foot problems: The role of the practice nurse

Abstract

As the number of people being diagnosed with diabetes continues to increase, practice nurses need to understand the associated conditions. Linda Nazarko explains diabetic foot care, the development of ulcers, and methods to support people with diabetes Around 1.4 million people in the UK had diabetes mellitus (DM) in 1996 ( Diabetes UK, 2010 ). There are now 3.59 million people who have been diagnosed ( Diabetes UK, 2017 ). In the past, diabetic foot care was managed by podiatrists; however, in recent years practice nurses have begun to undertake diabetic foot assessments ( Lakha and Lee, 2018 ). DM increases the risk of foot problems and the person with diabetes is vulnerable to major complications, including ulcers and amputations. A person with DM is 30 times more likely to require an amputation than a person without diabetes ( Khanolkar et al, 2008 ). Every day, 20 people with diabetes have a lower limb amputation in England ( Diabetes UK, 2016 ). Routine foot care assessments and risk ratings can enable the nurse to determine the patient's level of risk and know when to refer; they can also determine the frequency of monitoring. The practice nurse can also educate and support the person with diabetes to manage their health to reduce the risks of foot problems. Simple interventions such as smoking cessation, inspecting feet daily, seeking help if there are any concerns, and wearing suitable footwear can reduce the risk of ulcers and amputations and improve quality of life. This article aims to enable the practice nurse to understand the components of diabetic foot care, the reasons why people with diabetes develop foot ulcers, and to enable the practice nurse to provide appropriate care and support to people with diabetes.