Diabetes Foot CareDiabetes can be dangerous to your feet - even a small cut can produce serious consequences. Diabetes may cause nerve damage that takes away the feeling in your feet. Diabetes may also reduce blood flow to the feet, making it harder to heal an injury or resist infection. Because of these problems, you may not notice a foreign object in your shoe. As a result you could develop a blister or a sore. This could lead to an infection or a non-healing wound that could put you at risk for an amputation.
It is important that diabetics inspect their feet daily, preferably once in the morning and once in the evening, for any signs of injury or swelling in the foot. Diabetic foot involves a loss of feeling in the lower limb which means that many diabetics won’t notice that their feet have been damaged until injuries are significant. A mirror might be necessary to adequately inspect the underside of the foot.
Feet should be regularly and thoroughly washed with soap and warm water before being carefully dried and moisturised. Podiatrists can provide a specialist moisturiser, and the purpose of this is to prevent dry skin from cracking and becoming vulnerable to infection. These moisturisers shouldn’t be used in the spaces between toes as it is a confined, warm, and humid area susceptible to fungal infections.
Socks and shoes should be kept clean and dry, socks in particular should be changed on a daily basis and kept loose so as not to restrict the already poor blood flow typical of diabetic feet. Before wearing either socks or shoes diabetics should carefully inspect their shoes and socks as small stones, for example, can injure the foot.
Having diabetes increases the risk of developing a wide range of foot problems, often because of two complications of the disease: nerve damage (neuropathy) and poor circulation.
For those with diabetes, small foot problems can turn into serious complications, including:
• ulcers (sores) that don’t heal
• cracked heels
• ingrown toenails
Untreated diabetes can result in other conditions, such as:
• Diabetic peripheral neuropathy - this condition doesn’t emerge overnight. Instead, it usually develops slowly and worsens over time. Some patients have this condition long before they are diagnosed with diabetes. Having diabetes for several years may increase the likelihood of having diabetic neuropathy.
• Charcot foot - a condition in which the bones of the foot are weakened enough to fracture. With continued walking the foot eventually changes shape. As the disorder progresses, the joints collapse and the foot takes on an abnormal shape, such as a rocker-bottom appearance.
• To prevent complications of diabetes, patients are advised to follow diabetic foot care guidelines. Sometimes special diabetic shoes are prescribed to avoid pressure and rubbing on the feet caused by regular footwear.
Diabetic Foot Care Guidelines
1. To avoid serious foot problems that could result in losing a toe, foot, or leg, follow below given guidelines.
2. Inspect your feet daily. Check for cuts, blisters, redness, swelling, or nail problems. Use a magnifying hand mirror to look at the bottom of your feet. Call your doctor if you notice anything.
3. Wash your feet in lukewarm (not hot!) water. Keep your feet clean by washing them daily. Use only lukewarm water - the temperature you would use on a newborn baby.
4. Be gentle when bathing your feet. Wash them using a soft washcloth or sponge. Dry by blotting or patting, and carefully dry between the toes.
5. Moisturize your feet – but not between your toes. Use a moisturizer daily to keep dry skin from itching or cracking. But DON’T moisturize between the toes – that could encourage a fungal infection.
6. Cut nails carefully. Cut them straight across and file the edges. Don’t cut nails too short, as this could lead to ingrown toe nails. If you have concerns about your nails, consult your doctor.
7. Never treat corns or calluses yourself. No “bathroom surgery” or medicated pads. Visit your doctor for appropriate treatment.
8. Wear clean, dry socks. Change them daily.
10. Avoid the wrong type of socks. Avoid tight elastic bands (they reduce circulation). Don’t wear thick or bulky socks (they can fit poorly and irritate the skin).
11. Wear socks to bed. If your feet get cold at night, wear socks. NEVER use a heating pad or hot water bottle.
12. Shake out your shoes and feel the inside before wearing. Remember, your feet may not be able to feel a pebble or other foreign object, so always inspect your shoes before putting them on.
13. Keep your feet warm and dry. Don’t let your feet get wet in snow or rain. Wear warm socks and shoes in winter.
14. Never walk barefoot. Not even at home! Always wear shoes or slippers. You could step on something and get a scratch or cut.
15. Take care of your diabetes. Keep your blood sugar levels under control.
16. Don’t smoke. Smoking restricts blood flow in your feet.
17. Get periodic foot exams. Seeing your foot and ankle surgeon on a regular basis can help prevent the foot complications of diabetes.
Diabetics are also advised to avoid walking anywhere, even at home, bare foot. Slippers with hard soles are particularly recommended as they prevent any accidental scratching or cutting of the foot. Finally diabetics are advised to avoid using heat generating pads or bottles as the limited sensation in their feet can leave them vulnerable to accidental burning. Clean, warm socks are recommended as a much safer alternative. This advice will be proffered by podiatrists, and offers a good basis for regular and healthy foot care. Ultimately the care of diabetic feet is both the responsibility of podiatrists and the patient, who can ensure adequate foot health by working together.
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