Sometimes it’s the eyes that can be the first sign of a systemic illness. Sometimes it’s the feet.  Many of you know that the increasingly common chronic illness of diabetes can affect both feet and eyes.  But did you know that there are a number of other illnesses that can cause changes to occur on the feet? Before we delve into that, let’s discuss HOW diabetes can affect the feet.

Diabetes can cause microvascular changes. Tiny arteries that supply blood to the feet and toes become compromised, affecting circulation, sweating, muscle tone, and skin and nail health. Nerves can be affected as well, resulting in tingling, numbness, pain or the odd sensation of pressure, or of something being stuck to the feet.  The appearance of the foot can change due to muscle wastage, resulting in a more high arched foot and sometimes very prominent tendons on top. Pressure points increase, leading to more callus and sometimes ulcers as reduced blood flow and compromised immunity challenge the normal wound healing processes. The skin can become dry and nails brittle.

Podiatrists are expert in wound care and limb salvage. We do this through encouraging a healthy wound bed via debridement, dressings and very importantly, pressure offloading. A multi-disciplinary team gives the best outcome as doctors, podiatrists, endocrinologists, diabetes educators and wound care nursing work together in a holistic approach.

There are many other changes to finger or toe nails that can be a sign of something wrong systemically; club or spoon shaped nails, pincer nails, parrot beak nails, overly large or small nails, longitudinal ridging, transverse curved lines on all nails, pitting of the nails, changes in colours not due to a localised fungal infection, longitudinal or transverse brownish/black pigmentation, yellowing of all nails, may be clues to an underlying systemic disorders such as renal, thyroid, auto-immune or cardio-vascular disease, as well as many other systemic diseases.

If you notice any changes in your nails, your podiatrist can help rule out a localized cause such as trauma or infection. If there is any suspicion of a greater problem, you may be referred to your general practitioner for further assessment, or a High Risk Foot Clinic.