Don’t Be De-Feet-ed: Foot Care For Diabetic Patients

Proper foot care is essential for diabetic patients, since damage to nerves or blood vessels in the feet can lead to diabetic foot problems. Paying daily attention to your feet can alert you to any conditions that could lead to amputation of toes, feet, or legs if left untreated.

Diabetes lowers the ability of the immune system to effectively fight infections, and small infections can quickly become serious ones that may cause tissue death and require amputation to save your life. You are especially at risk of foot problems if you have had diabetes for 10 years or more, are male, have poor blood glucose control, and have eye, kidney, or heart problems related to diabetes. Follow these simple steps to reduce your risk of diabetic foot problems.

Daily Foot Hygiene
Washing your feet daily gives you the opportunity to notice any changes in your feet. Any sores or ulcers that don’t heal, corns or callouses, changes in the shape of your feet, foot pain, or loss of feeling should be reported to your physician as soon as possible. Check all parts of your feet: top, bottom, between the toes, sides, and heels. Use a plastic mirror, if you need to, to check the soles of your feet. If you are obese and can’t reach your feet, you may need to ask a family member to do this foot check for you.

When washing your feet, use lukewarm (not hot) water and a mild soap. Don’t allow your feet to soak a long time, but give them a good lathering and rinse them well. Dry your feet thoroughly, especially between the toes where moisture can cause fungal infections. Keep your feet dry during the day by sprinkling talcum powder or corn starch between your toes before you put on your socks.

Skin changes can cause diabetic feet to become dry and cracked, and set the stage for infection. Keep the skin on your feet soft and smooth by applying a skin lotion or cream, or petroleum jelly on them after they have been thoroughly dried. Smooth lotion over the tops and bottoms of your feet, but not between the toes.

Corns and Callouses
Bring corns and callouses to your doctor’s attention and ask how to care for them. He may recommend that you use a pumice stone, found in the health & beauty aids department of most stores, to smooth rough spots on your feet. Use the pumice stone carefully on the corn or callous after your feet have been washed, rubbing lightly in one direction only. Don’t scrub or rub in circles, which can tear the skin on your feet.

Never use a sharp instrument to remove corns or callouses. Don’t use corn plasters or liquid corn and callous removers, or other antiseptic solutions which can damage the skin on your feet.

Toenail Care
Use toenail clippers to trim your nails straight across, and smooth rough edges with an emery board or nail file. Clipping after your feet have just been washed will make the nails softer and easier to cut. Don’t cut into the corners, which can encourage ingrown toenails. If your vision isn’t good, or you have thickened, yellowish, or ingrown toenails, allow your foot care doctor to trim your toenails for you.

Shoes and Socks
Wear shoes and socks at all times, even indoors, to protect your feet. Even a small nick or cut can set you up for an infection which could lead to the loss of a toe, foot, or leg. At the beach or pool, wear swim shoes for protection.

Always wear stockings, socks, or nylons with well-fitting shoes to prevent blisters. Avoid socks or garters that are tight around your legs and restrict blood flow, or that have seams that will create pressure points. Check the insoles before you put your shoes on to make sure the inside isn’t torn or rough. Shake the shoes before putting them on, to dislodge any small rocks or tiny toys you might not be able to feel which could cause a sore on your foot.

Leather shoes are preferable over synthetics, to allow moisture and perspiration to evaporate. Shoes should have firm soles and soft uppers. Ladies’ dress shoes should have an ankle strap to hold the heel onto the shoe. Change your shoes after five hours of wear, to change pressure points.

Protect Your Feet From Extremes of Hot and Cold
Nerve damage may cause you to lose sensation in your feet, and you may not be aware of how hot or cold your feet really are. Avoid putting your feet too near an open fire, radiator, heating pad, electric blanket, or other heat source so you don’t get burned accidentally. Never walk barefoot on the beach, where the sand can be quite hot, or on hot pavement.

In cold weather, wear socks to bed. Wear warm, lined boots in the winter, and if you are outdoors in cold weather for any length of time, be sure to check your feet occasionally for frostbite.

Keep Blood Flowing To Your Feet
Get a moderate amount of exercise to keep your circulation healthy and adequate blood flowing to your feet. Choose a form of exercise that is easy on the feet: walking, dancing, swimming, and bicycling are all good choices. Avoid running and jumping, which are hard on the feet. Wear athletic shoes that fit well and provide cushioning.

If your health doesn’t allow much physical activity, sit with your feet elevated as much as possible. Avoid sitting with your legs crossed for long periods, which inhibits blood flow to the lower extremities. Wriggle your toes for five minutes at a time, two or three times a day, and exercise your ankles by moving your feet in a circular motion, and back and forth to encourage blood circulation.

Follow Your Doctor’s Advice
Manage your diabetes as your doctor instructs, whether it is through diet and lifestyle changes, medication, or both. Stop smoking, which hinders blood circulation.

Your physician should check your feet at least once a year if you haven’t had any foot problems up to this point. Your physician should be checking your feet at each appointment if you already have problems with your feet as a result of your diabetes.

Ask your doctor about customized shoes or orthotic devices that may be covered by insurance or Medicare, or if he would recommend that you be seen by a foot care specialist.

Prevention
Keeping your blood glucose lowered is the best way to avoid foot problems as a result of diabetes, and preventing foot problems will avoid the potential amputation of a toe, foot, or leg. Managing your diabetes under the direction of your physician reduces your risk of other long-term health problems as well.

This article is for information only, and not meant to replace your doctor’s advice.

Sources:
http://ndep.nih.gov/campaigns/Feet/Feet_overview.htm#Blood
http://www.nlm.nih.gov/medlineplus/ency/article/003937.htm

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