PREVENTION PROGRAM FOR DIABETIC PATIENTS: FEET CARE

Foot care is of the outmost importance to diabetic patients, especially if they suffer from:

• Loss of sensation in their feet
• Changes in the structural form of the feet
• Swellings or water blisters, lacerations, cracks or sores that do not heal easily

 

Avoid complications that could result in partial or total amputations of one or both feet.  Caring for your feet and avoiding complications is easy if you establish a plan and see it through with diligence.  This guide will help you adequately care for your feet.

Damage to nerve endings (diabetic neuropathy) can be, in the majority of cases, caused by the loss of sensation in the feet.  If you lack sensation in your feet, you will not feel, for example, that you have a rock in your shoe that might otherwise cause you pain, nor will you feel swelling or water blisters caused by wearing shoes that are the incorrect size. Simple foot trauma, such as these, can cause sores that. If not treated correctly, could result in amputation, excessive trips to the doctor, or even death.

Keeping your blood glucose level under control and taking proper care of your feet will help you avoid any complications.

Home Orthopedics created this suggestion guide to help you establish a plan to care for your feet. It’s always a good idea to consult with your primary care doctor or your endocrinologist to establish a plan to properly care for your feet. 

GUIDELINES TO CONTROLL YOUR BLOOD GLUCOSE LEVEL:

• You can maintain a healthy lifestyle by controlling your blood glucose level, lowering your blood pressure and by reducing your cholesterol
• Work with your doctor or health service provider to establish a plan for controlling your diabetes
• Request an A1C test on a regular basis.  The A1C test will inform your doctor of any fluctuations in your blood glucose level.
• Learn to self-administer the glucose test at home
• Remember to take your medications as prescribed

Remember to eat healthy; low fat and low sugar foods with plenty of fiber, including fruits and vegetables. Below is a suggested list to assist you when shopping:

• Tomatoes
• Apples
• Pears
• Papaya
• Guava
• Avocados
• Spinach
• Grapes
• Blueberries
• Garbanzos
• Lettuce (It’s better to get whole leaf – hydroponic is fine) rather than iceberg
• Black & Red beans

Visit your dentist at least twice a year.

EXAMINE YOUR FEET ON A DAILY BASIS

It’s important to examine your feet on a daily basis in order to catch any abnormalities as soon as they arise. Due to frequent loss of sensation in your feet, you could be suffering from a serious problem without feeling any pain or discomfort.

If you have difficulty seeing the sole of your foot, use a mirror or ask a family member, friend or caretaker to thoroughly inspect your feet.

During your visual inspection, you should be checking for:

• Any irritation on the skin
• Cuts
• Cracks
• Swelling
• Water blisters
• Red areas
• Impacted or infected nails
• Fungus
• Flakey or rough skin

Make sure to consult your doctor if you notice a lesion on your foot that does not heal quickly, even if it doesn't cause any pain.

WASH YOUR FEET ON A DAILY BASIS

Wash your feet using warm (never hot) water and soap.

Before dipping your feet, test the water temperature with your elbow or with a thermometer. The temperature should be around 90°.  

If you've lost, or are losing sensation in your feet as a result of diabetes, you'll be unable to notice if the water is hot and could burn yourself without feeling any pain.

To avoid skin damage, do not immerse your feet for more than 10 minutes.  After washing your feet, dry them well.  Use talcum powder to keep the skin between your toes free of humidity.

KEEP YOUR SKIN SOFT AND HYDRATED

• Apply a thin layer of hydrating cream, such as Diabeskin, to keep the skin of your feet hydrated
• Never apply cream between your toes.  This could cause infections or fungus.
• If you have calluses or rough patches on your feet, consult with your doctor or podiatrist about the best way to treat them
• If your doctor or podiatrist authorizes it, use a pumice stone to reduce roughness.  Rub the rough patches softly with the stone in the same direction to avoid irritating your skin.
• Never attempt to remove, cut, or eliminate calluses yourself using razors, creams or over the counter medication.  These could hurt and cause damage to your skin.  Visit your doctor or podiatrist to obtain the proper treatment.

FILE YOUR NAILS AND KEEP THEM CLEAN

• Consult with your doctor to see if you're capable of cutting your own nails or if you should see a podiatrist.
• Soak your feet in warm (never hot) water for one minute before cutting your nails. This softens the nail beds and makes them easier to cut.
• File your nails straight across.
• Remember to smooth out your nails using carton smoothers (Emery Boards).  Metal boards should never be used because they are harder and can splinter the nails of a diabetic patient.

If you find that it is too difficult to cut your nails yourself or if you notice that your nails are:

• Cracked
• Curved
• Yellowing
• Infected

You should visit your podiatrist as soon as possible.

NEVER WALK BAREFOOT OR USE SHOES WITHOUT SOCKS

Never walk barefoot.  The diabetic foot progressively loses sensation and increases the probability that you might step on something that might cause a lesion or you can hurt yourself.

To avoid irritation, swelling or water blisters, and lesions in your feet, never use shoes without socks.

Always use clean, comfortable socks that are neither too tight nor too loose.

Ideally, the most recommended are socks that don't have stitching and are made of a material that can absorb humidity, such as cotton.

Shake and inspect the interior of your shoes before putting them on.  Make sure there aren't any rocks, sand, paper, loose stitching or any irritating object inside the shoe.

When choosing shoes, keep in mind the following:

• The appropriate footwear, designed for diabetics, will help you avoid problems or grave complications to your feet
• Athletic footwear (tennis shoes) or walking shoes will be ideal for your daily use.  These shoes offer your feet good support and allow them to “breathe”.
• Never use shoes made of vinyl, plastic or any man made material.  These materials don't yield (stretch) according to your foot's movement while walking and don't allow them to breathe. This promotes moisture growth, which could turn into fungus.

When at home, you should use shoes or slippers for home use that are closed, with no interior stitching. It is recommended that you wear slippers that are especially designed for diabetics.

These special shoes, besides offering optimal support for your feet, will protect your toes against accidental bumps and potential foot trauma.  Additionally, they have thick soles to avoid slips and to protect your feet against any sharp object you may step on.

When choosing a shoe, make sure they're comfortable from the moment you try them on, and that you have enough space to move your toes.  Don't wait for the shoe to stretch so it feels comfortable.

Avoid pointy shoes.  These shoes will cram your toes one on top of one other creating pressure points, friction and bone deviation.

Avoid shoes with high heels; these create too much pressure on your toes and on the soles of your feet.

PROTECT YOUR FEET FROM THE COLD AND EXTREME HEAT

Always use shoes when walking over hot concrete or beach sand.  You could suffer serious burns to the soles of your feet and not feel any pain.

Apply sunblock to the upper part of your feet to avoid sunburn.

If you live in the country or an area that's extremely cold, take special care of your feet.  Keep them comfortable, protected from the cold, hydrated byapplying hydrating cream such as Diabeskin on a daily basis. Inspect them regularly to avoid damage from frostbite.  The low temperature, coupled with the loss of sensation, contributes to you not feeling any pain in your feet if you suffer any trauma.

Never use an electric blanket during the night.  Use clean and comfortable socks that aren't too tight or too loose.

TO PROMOTE GOOD BLOOD CIRCULATION

• Keep your feet elevated while you're seated
• For better blood circulation to your legs, move your toes for five minutes two to three times a day. Move your ankles up and down, as well as in and out.
• Avoid crossing your legs for long periods of time as this cuts off circulation
• Never use tight socks, elasticized or rubber bands around your feet or legs, as these could cut off blood circulation
• Don't smoke.  Smoking, among other things, reduces the blood flow to your legs and feet.
• Ask your doctor for help maintaining an optimal level of blood glucose, as well as blood pressure and cholesterol