More than three million people are living with diabetes, with another 600,000 undiagnosed, but Essex footcare specialist, Lesley Tanner, can help.

Cleaning out our ears and trimming our toenails are among the list of regular ablutions we aim to undertake on a regular basis.

But if you are living with a life-long condition, the simplest thing likemaking sure you look after your feet and toenails might mean avoiding having a limb amputated.

North Essex footcare specialist Lesley Tanner, who runs clinics in Colchester and Tendring from her Kirby office, as well as making regular calls in the community, says foothealth in diabetes is not improving.

She says education is the answer and is trying to raise awareness over the issue to help diabetes sufferers.

Diabetes is one of the leading causes of death in the UK, alongside breast cancer, testicular cancer and ovarian cancer.

Just over three million people are living with the condition, with more than an estimated 600,000 undiagnosed.

More than twomillion of those living with the condition have type 2, which is most associated with lifestyle and often brought on by obesity.

The NHS spends 20 per cent of its budget on foot treatment and complications with £300million spent each year on managing ulcers caused by diabetes.

Lesley says: “This is a major health crisis we could help purely by education.

“Although it is a common lifelong condition affecting eyesight long term, it can also affect the liver, cause strokes and heart problems as well as infection on the foot.

“This leads to ulcers that can lead to gangrene and amputation. One in ten people with diabetes gets foot ulcers, which makes them 15 times more likely to have amputations,” adds Lesley.

Something simple like keeping toenails short and regularly checked to avoid an in-growing toenail could prevent a foot or leg being amputated, she says.

“When someone has diabetes, it could lead to the nerve endings being affected so youwould not necessarily feel the pain of the beginnings of an in-growing toenail until it was too late.

“Or youmight get a stone in your shoe and if the nerve endings are affected, not feel it until it has become infected or gangrenous.

“Patients with diabetes, if not aware how serious this condition is, should take time to consult a foot health practitioner not just for regular care, but simply a chat if they are unsure of anything at all.

“Education is the key factor here to improve this very serious condition affecting more and more people every day.”

Lesley, who retrained as a footcare specialist after a number of years as a weightloss consultant, says she is urging everybody, but those with diabetes in particular, to get into the habit of visiting a footcare professional every six weeks to have a foot health check, their toenails cut and hard skin removed.

And if that is not possible, then to make sure you go at least once a year.

She explains annual foot checks will involve feet being examined for any changes, including looking for corns and hard skin.

But she says people should actually be checking their feet every day for any changes including redness, pain, buildup of hard skin and changes in the nails.

“Prevention is always the better option, and education always better than amputation,” adds Lesley.

Helen Sanderson, lead nurse specialist for the wound management team at Southend Hospital, says it is a problem that is not going away.

She agrees education, and patients taking responsibility for their condition and maintaining their health, will be the key to reducing serious complications.

She says Southend University NHS Trust Foundation, which runs the hospital, set up its multi-disciplinary footcare team in 2007 for dealing with wounds of all natures but says treating diabetes patients forms amajor part of its work.

“We are unique in that we have an in-patient service.

Since it was introduced the number of lower limb amputations has been reduced by more than 60 per cent which is a massive drop.

“Admittedly, there has been a slight increase in toe amputations but sometimes you may have to lose a toe in order to save a leg,” explains Helen.

But she agrees education has to be the key as even though South Essex patients benefit from the excellent service they offer, sometimes it is just too late when an ulcer has begun to develop.

“You are more likely to survive breast cancer than have diabetes and not suffer some sort of problem with your feet, eyes or kidneys, as well as running the risk of stroke or a heart attack.

“It is a serious health issue.

Having diabetes is a risk, no doubt about it, but by eating healthily, managing medication well, checking your feet regularly and being aware, you may be able to limit the risk of complications.”

COMPLICATIONS COST ME A LEG ...BUT I'VE GOT MY LIFE BACK ON TRACK 

DAVID Sach knows the extent to which diabetes can affect sufferers after he had to have his left leg amputated earlier this year.

The 61-year-old was diagnosed with type 1 diabetes at the age of 20. The condition runs in his family and he managed it successfully until five years ago, when he developed a diabetic ulcer after treading on a rusty nail.

Foot ulcers can happen to anyone, but for people with diabetes the skin may not heal properly because of nerve damage caused fluctuating blood sugar. Unfortunately this was the case for David, and he had to have part of his foot removed, and wear a special boot. But within a year his foot became seriously infected.

But David has nowmade a rapid return to normal life, thanks to his positive attitude and the support of the hospital amputee rehabilitation team.l.

David said: “I had been feeling so unwell I knew something was badly wrong.

Every bone in my foot was infected. I spent three months in hospital, and was offered more surgery and a skin graft, but the doctor said they could not guarantee it would solve the problem, so I decided to opt for an amputation below the knee.”

The operation was carried out in May this year, and David was placed under the care of the amputee rehabilitation team at Basildon Hospital. He attended twice a week and on the days at home between sessions was careful to carry out the exercises recommended by the therapists.

Laura Jones, physiotherapist, said: “David was a model patient and progressed very quickly. He always worked hard and was proactive about asking what more he could do. His positive attitude really helped his treatment.”

After two months, David was fitted with an artificial leg and continued attending rehab.

He has returned to his job at a supermarket in Corringham and says he is enjoying life again with his wife Jillian.

He recently attended rehab gymat Basildon Hospital for an amputee information event, where Jane Webb from the Limbless Association spoke to a group of patients about support and services available for amputees, and also fundraising events.

David said: “After I made the decision to have my leg amputated, I wondered if it was the right thing to do, but it definitely was.

“I am free from infection, back at work and we are planning our first holiday in five years – it was very hard on my wife, she had to give a lot of things up, or go out alone, but nowwe can do things together again. The dog is also happy – I can now do everything I did with two legs, including taking him for walks.

“The more you put into your recovery, the better you get on.

The therapists ask people after an amputation what their goals are.

“I said I wanted to be back at work within six months, and I did it in half the time. I took the attitude I wanted to get my life back.

“I would say to people with diabetes, please treat it seriously and always attend your medical appointments because the complications can be life-changing.”

LOOKING AFTER MY FEET IS IMPORTANT  

DIAGNOSED with type 2 diabetes 13 years ago, Joanne Clarke says she has always known it is important to look after herself as a result.

Joanne, who runs her own business in Colchester, openly admits she was seriously overweight at the time.

Since then she has shed around seven stone in a bid to keep her illness manageable and regularly visits Lesley’s clinic in order to maintain the health of her feet.

She explains: “I was diagnosed when I was 34, so I have lived with it for a long time.

“I lost seven stone and I am still overweight, but the condition is a lot more manageable with having lost that weight and I am always trying to get it down even more.

“It has meant my sugar levels have gone down but it is a constant battle.

“One of the key things, as well, is looking after my feet,” adds Joanne, 47.

She explains as well as having regular check-ups on her eyes, and a yearly foot check-up from her GP, she also goes to Lesley every six to eight weeks.

“I have done that since I moved into the area about five years ago. That way, if something changed she would be the first to notice as getting them looked at once a year is not enough.

“She removes the hard skin and makes sure there is no in-growth on the toenails. It is a bit like a pedicure but without the nail varnish.

“I am lucky that so far I have not got the damage to nerve endings some people with diabetes have which make not looking after your feet very dangerous, but it could happen so it is really important to get my feet checked on a regular basis,” says Joanne, of Welshwood Park Road, in Colchester.

ABOUT DIABETES...

THERE are two main types of diabetes: Type 1 and Type 2.

Common signs for diabetes can include going to the toilet, especially at night, feeling really thirsty, feeling more tired than usual, losing weight without trying to, cuts and wounds taking longer to heal and blurred vision.

Having some of these signs does not necessarily mean you have the condition, but you should see a doctor.

These symptoms occur because some or all the glucose stays in the blood,and isn’t being used as fuel for energy.

The body tries to reduce blood glucose levels by flushing the excess glucose out of the body in the urine.

Symptoms of Type 1 can often appear very quickly and leaving it untreated can lead to serious health problems.

Type 2 can be easier to miss as it develops more slowly, especially in the early stages when it can be harder to spot the symptoms.

Being diagnosed early and controlling blood sugar levels can help prevent complications.