| Subject | Contents |
| Definition | |
| Alternative Names | Foot care for diabetics |
| Information | People with diabetes are prone to foot problems because complications of the disease can cause damage to the blood vessels and nerves. This, in turn, may result in a decreased ability to sense trauma or pressure on the foot and a foot injury may go unnoticed until severe infection develops. Diabetes also alters the immune system, thus decreasing the body's ability to fight infection. Small infections can rapidly progress to death of the skin and other tissues ( necrosis ), which may require amputation of the affected limb to save the patient's life. Foot problems can be prevented in part with improved blood sugar control.
Diabetics at high risk for developing foot problems include those with diabetes for more than 10 years, males, those with poor glucose control, those with eye, kidney, heart complications. All diabetics should get regular (at least twice yearly) foot exams by their health care provider and should learn whether they have nerve damage.
To prevent injury to the feet, diabetics at high risk for foot problems, those with known nerve damage, and those with current foot problems should adopt a DAILY routine of checking and caring for the feet as follows: Check the feet every day. Inspect the top, sides, soles, heels, and between the toes. Wash the feet every day with lukewarm water and mild soap, and dry them thoroughly, especially between the toes. Strong soaps may damage the skin. Test the temperature of the water before immersing the feet, because the normal ability to sense hot temperature is usually impaired in diabetics and burns can easily occur. Also, be sure to gently and thoroughly dry the feet, particularly between the toes, because diabetics are at high risk for developing infections, especially in moist areas. Avoid applying a heating pad or hot water bottle to the feet. Avoid hot pavement or hot sandy beaches. Wear socks to bed if your feet are cold. In cold weather, wear warm socks and limit your exposure to the cold to prevent frostbite . Apply a thin coat of lubricating oil or lotion after bathing the feet. Because of the skin changes associated with diabetes, the feet may become very dry and may crack, potentially causing an infection. Soften dry skin with lotion, petroleum jelly, lanolin, or oil. Do not put lotion between your toes. Protect the feet with comfortable, well-fitting shoes. Never buy shoes that do not fit properly, expecting the shoes to stretch with time. Neuropathy may prevent you from being able to sense pressure from improperly fitting shoes. Also, check the inside of your shoes for rough areas or torn pieces that can cause irritation. Change your shoes after 5 hours of wearing during the day to alternate pressure points. Avoid wearing thong sandals or stockings with seams that can cause pressure points. Wear clean dry socks or non-binding panty hose every day. Socks may provide an additional layer of protection between the shoe and your foot. Wear shoes at all times to protect the feet from injury. Decreased vision and impaired ability to detect pain may cause minor cuts or bumps to go unnoticed.Exercise daily to promote good circulation. Avoid sitting with legs crossed or standing in one position for prolonged periods of time. Ask your health care provider to show you how to care for your toenails. Soak your feet in lukewarm water to soften the nail before trimming. Cut the nail straight across, since curved nails are more likely to become ingrown. Make an appointment with a podiatrist to treat foot problems or to have corns or calluses removed. Never attempt to treat these yourself using over-the-counter treatments. Avoid using antiseptic solutions on your feet since these are very caustic and can cause skin injury. Remove shoes and socks during a visit to the health care provider as a reminder that you need a foot exam. Discontinue smoking because it decreases blood flow to the feet. Report sores, changes and/or signs of infection immediately. Report all blisters , bruises, cuts, sores or areas of redness. Foot care should be a part of the diabetic person's daily routine. Lack of sensation in the feet necessitates even closer daily observation. Obesity may prevent the person from being physically able to view their feet so family member, neighbor, or a visiting nurse may need to perform this important monitoring. |
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