Diabetic Foot Care:Ten Tips
by Christine Dobrowolski, DPM
www.skipublishing.com
Posted Mar 10th 2007,
Read 249 times since then.
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It is estimated that over 18 million Americans have diabetes. About 10 million diabetics are between the age of 20 to 60. Most individuals in this age group have type 2 diabetes. With type 2 diabetes the body produces insulin, but it does not produce enough of this hormone or the cells don't respond appropriately to it. The result is an elevated blood sugar and sometimes an elevated insulin level as well. The blood sugar is high because the sugar is not being taken into the cells and utilized for energy properly. Most of the diabetics over the age of sixty have type 2 diabetes.
Serious complications associated with diabetes include stroke, heart disease, blindness, kidney disease, high blood pressure, nervous system diseases and amputations. In 2002 there were 82,000 lower extremity amputations in diabetics. Six individuals out of every 1,000 people with diabetes will have a lower extremity amputation. A slow healing or non-healing open sore (known as an ulceration) on the foot is the most common reason diabetics will end up with a foot or leg amputation. Over 2 million diabetics have ulcerations and one in four diabetics with an ulcer will have an amputation. Unfortunately, over 25% of diabetics have not heard of an ulcer.
Treating diabetic ulcers is difficult. Preventing diabetic foot complications is not. Preventing diabetic ulcerations is the key in decreasing the risk of amputation. It is important to see a podiatrist for diabetic checkups every two months to help keep ingrown nails, corns and calluses from becoming a problem.
Take these steps to help prevent diabetic foot complications:
1. Check your feet everyday! This is an absolute necessity. If you can’t reach your feet, have a friend or family member check your feet. If needed, put a mirror on the floor and put your foot over it to look for cuts, scraps, bruises, openings or areas of irritation. Make sure you check between your toes. Look for moist areas, white areas or red areas. Look for anything unusual. If you see something unusual, make an appointment with your podiatrist.
2. Don’t walk around barefoot. Needles, tacks, broken glass, splinters of wood can be hidden in the carpet, even if you vacuum regularly. You can puncture a foot without sensation. Punctures can go unnoticed and develop into ulceration or infections.
3. Watch out for folds in your socks. Rough seams in the socks can cause areas of irritation that may lead to skin breakdown and ulceration. This can also result from small folds in the socks.
4. Don’t be a victim of fashion. High fashion shoes usually lead to a high number of problems in the feet. Make sure the shoes are wide enough. Don’t buy shoes that are too wide or too long which can cause a lot of slipping. Pick shoes that are soft and flexible and allow for cushioning on the top and sides, but are rigid on the sole. Make sure they don’t fold in half. You may be eligible for your insurance to pay for diabetic extra-depth shoes with custom insoles. These shoes will take the pressure off your feet. Ask your doctor.
5. Check your bath water with your hand before you put your foot in it. The temperature your foot feels is much different from the temperature your hand feels when you have neuropathy. Make sure to check the temperature with your wrist. This will be much more accurate than testing the water with your foot.
6. Avoid medicated corn pads. Medicated corn pads contain acid and can be dangerous to diabetics. Yes, it will remove the corn, but there is a good chance it will also remove all the surrounding skin. What you will be left with is an ulceration. Check foot products you buy to make sure they are safe for diabetics.
7. Dry between your toes. Increased moisture between your toes can lead to the skin breaking down. This will eventually lead to an ulcer between the toes. Ulcers between the toes go unnoticed for longer periods of time and they can be difficult to treat.
8. Don’t use a heating pad on your feet. Although many diabetics complain about cold toes, a heating pad is not a good way to warm them up, if you have neuropathy. The heating pad could be placed too high and cause a burn, without you knowing it.
9. Know your risk. Some diabetics do not have any loss of sensation or circulation in their feet. They are not at risk of developing a ulceration and have a low risk of an infection becoming a problem. Others, have severe neuropathy or circulation problems and don’t know it. It’s important to know where you stand. You want a podiatrist to evaluate you and tell you what your risk is, and the steps you need to take to prevent these things from happening.
10. Do not trim your own toenails, calluses or corns. If you have a loss of sensation or blood supply then have your podiatrist trim your corns, calluses or toenails.
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