'Diabetic foot' affects more than just your feet

Managing diabetes requires careful consideration of lifestyle habits, medication, and monitoring, which can be hard! But one area that many people aren't as aware of, is how diabetes affects their feet. If you begin to develop foot problems there’s, even more, to think about, from extra medical appointments to daily self-care for your feet.

Researchers from Israel were therefore concerned to find that people with diabetes-related foot ulcers may be more likely to have cognitive problems which could affect their ability to properly care for their feet.

In one of the first studies looking at this relationship, researchers compared 99 individuals with a diabetes-related foot ulcer with a similar number of people with type 2 diabetes who didn’t have a foot ulcer.  Both groups were aged between 45 and 75 years and had been diagnosed with diabetes for similar length of time.  The study participants underwent a range of cognitive tests which looked at factors including memory, executive function, reaction time, attention and psychomotor abilities.

Compared to those without a foot ulcer, the people with a diabetes-related foot ulcer were found to have lower scores in all of the areas tested. 

The group with ulcers also had a higher HbA1c (which reflects average blood glucose levels of the past 2-3 months) and a higher risk of other diabetes-related complications.  But even when the researchers controlled for possible confounding factors including smoking, HbA1c, macrovascular (large blood vessel) disease and depression, they still saw a difference in cognitive function between the two groups.

These findings suggest that people with a diabetes-related foot ulcer may remember less, have decreased ability to concentrate, and more difficulty with learning, less inhibition, slower cognitive and psychomotor responses, and less verbal fluency.   The authors suggest that this could make it more difficult for them to implement the treatment recommendations which are important for managing their foot ulcer.

The study only shows an association between diabetes-related foot ulcers and cognitive problems, and doesn’t prove that one causes the other. However, considering that they are more likely to occur together, the study authors encourage health professionals to screen individuals with diabetes-related foot complications for cognitive problems and to take cognitive abilities into consideration when planning treatment recommendations and follow-up. 

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