Diabetic Foot
Diabetes is a serious disease that can develop from the lack of insulin
production in the body or due to the inability of the body’s insulin to
perform its normal everyday functions. Insulin is a substance produced
from the pancreas gland that helps process the food we eat and turn it
into energy.
Diabetes affects approximately 16 million Americans and is classified into
2 different types: Type 1 and Type 2. Type 1 is usually associated with
juvenile diabetes and is often linked through heredity. Type 2, commonly
referred to as adult onset diabetes, is characterized by elevated blood
sugars, often by people who are overweight or have not attended to their
diet properly.
There are
often many complications associated with diabetes. Diabetes disrupts the
vascular system, affecting many areas of the body such as the eyes,
kidneys, legs, and feet. People with diabetes should pay special
attention to their feet.
CAUSE
Neuropathy
Of
the sixteen million Americans with diabetes, 25% will develop foot
problems related to the disease. Diabetic foot conditions develop from a
combination of causes including poor circulation and neuropathy. Diabetic
Neuropathy can cause insensitivity or a loss of ability to feel pain,
heat, and cold. Diabetics suffering from neuropathy can develop minor
cuts, scrapes, blisters, or pressure sores that they may not be aware of
due to the insensitivity. If these minor injuries are left untreated,
complications may result and lead to ulceration and possibly even
amputation. Neuropathy can also cause deformities such as Bunions, Hammer
Toes, and Charcot Feet.
It is very important for diabetics to take the necessary precautions to
prevent all foot related injuries. Due to the consequences of neuropathy,
daily observation of the feet is critical. When a diabetic patient takes
the necessary preventative footcare measures, it reduces the risks of
serious foot conditions.
Poor
Circulation
Diabetes often leads to peripheral vascular disease which inhibits a
person’s blood circulation. With this condition, there is a narrowing of
the arteries that frequently leads to significantly decreased circulation
in the lower part of the legs and the feet. Poor circulation contributes
to diabetic foot problems by reducing the amount of oxygen and nutrition
supplied to the skin and other tissue, therefore causing injuries to heal
poorly. Poor circulation can also lead to swelling and dryness of the
foot. Preventing foot complications is more critical for the diabetic
patient since poor circulation impairs the healing process, and can lead
to ulcers, infection, and other serious foot conditions.
TREATMENT & PREVENTION
Footwear and orthotics play an important role in diabetic footcare.
Orthotics designed with Plastazote“ foam, the #1 material for protecting
the insensitive diabetic foot, are usually recommended. Plastazote is a
material designed to accommodate pressure “hot spots” by conforming to
heat and pressure. By customizing to the foot, Plastazote provides the
comfort and protection needed in diabetic footcare. Footwear constructed
with Plastazote is also recommended frequently for the diabetic patient.
Diabetic Footwear should also provide the following protective benefits:
-
High, wide toe box
(high and wide space in the toe area)
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Removable insoles for fitting flexibility and the option to insert
orthotics if necessary.
-
Rocker Soles These soles are designed to reduce pressure in the areas
of the foot most susceptible to pain, most notably the ball-of-the-foot.
-
Firm Heel Counters for support and stability.
If
you are a diabetic, you should be particularly alert to any problems you
may be having with your feet. It is very important for diabetics with
neuropathy to take necessary precautions to prevent injury and keep their
feet healthy. If you have diabetes and are experiencing a foot problem,
immediately consult with your foot doctor.
Footcare & Diabetes
Proper footcare is especially critical for diabetics because they are
prone to foot problems such as:
-
Loss of feeling in their feet
-
Changes in the shape of their feet
-
Foot ulcers or sores that do not heal
Simple daily footcare can prevent serious problems. According to the
National Institute of Health, the following are simple everyday steps that
will help prevent serious complications from diabetes:
-
Take
Care of Your Diabetes
Make healthy life style choices to keep your blood sugar close to
normal. Work with your health care team to create a diabetes plan that
fits your life style characteristics.
-
Check Your Feet Every Day
You may have foot problems that you may not be aware of. Check your
feet for cuts, sores, red spots, swelling, or infected toenails.
Checking your feet should become part of your daily routine. If you have
trouble bending over to see your feet, use a plastic mirror to help.
You can also ask a family member to help you.
Important Reminder Be sure to call your doctor immediately if a
cut, sore, blister, or bruise on your foot does not heal after one day.
-
Wash Your Feet Every Day
Wash your feet in warm, NOT HOT, water. Do not soak your feet because
your skin will get dry. Before bathing or showering, test the water to
make sure it is not too hot. You should use a thermometer or your
elbow. Dry your feet well. Be sure to dry between your toes. Use talcum
powder to keep the skin dry between the toes.
-
Keep the Skin Soft and Smooth
Rub a thin coat of skin lotion or crème on the tops and bottoms of the
feet. Do not put lotion between your toes, because this might cause
infection.
-
Trim your Toenails Each Week or When Needed
Trim your toenails with clippers after you wash and dry your feet. Trim
the toenails straight across and smooth them with an emery board or nail
file. DO NOT cut into the corners of the nail or rip off hangnails. If
you’re nails are thick or yellowed, DO NOT cut your own nails, have a
foot doctor trim them.
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Wear Shoes and Socks At All Times
Wear shoes and socks at all times. Do not walk barefoot, not even
indoors. It is extremely easy to step on something and hurt your feet.
Always wear seamless socks, stockings, and nylons with your shoes to
help avoid the possibility of blisters and sores developing. Be sure to
choose seamless socks that are made of materials that wick moisture away
from your feet and absorb shock and shear. Socks made of these
materials help keep your feet dry. Always check the insides of your
shoes before putting them on. Make sure the lining is smooth and there
are no foreign objects in the shoe, such as pebbles. Wear shoes that fit
well and protect your feet.
-
Protect Your Feet
From Hot and Cold
Always wear shoes at the beach or on hot pavement. Put sunscreen on the
tops of your feet for protection from the sun. Keep your feet away from
radiators or open fires. DO NOT use hot water bottle or heating pads on
your feet. If your feet are cold, wear seamless socks at night. Lined
boots are good to keep your feet warm in the winter. Choose socks
carefully. DO NOT wear socks with seams or bumpy areas. Choose padded
socks to protect your feet and make walking more comfortable. In cold
weather, check your feet often to keep your feet warm avoid frostbite.
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Keep the Blood
Flowing to Your Feet
Put your feet up when you are sitting. Wiggle your toes for 5 minutes, 2
or 3 times a day. Move your ankles up and down and in and out to
improve blood flow in your feet and legs.
-
DO NOT cross your legs for long periods of time.
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DO NOT wear tight socks, elastic, or rubber bands, or
garters around your legs.
-
DO NOT wear restrictive footwear or foot products. Foot
products that can cut off circulation to the feet, such as
products with elastic, should not be worn by diabetics.
-
DO NOT smoke. Smoking reduces blood flow to your feet.
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If
you have high blood pressure or high cholesterol, work with your health
care team to lower it.
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Be
More Active
Ask your doctor to plan an exercise program that is right for you.
Walking, dancing, swimming, and bicycling are good forms of exercise
that are easy on the feet. Avoid all activities that are hard on the
feet, such as running and jumping.
Always include a short warm-up or cool-down period. Wear protective
walking or athletic shoes that fit well and offer good support.
-
Communicate With Your Doctor
Ask your doctor to check the sense of feeling and pulses in your feet at
least once a year. Ask your doctor to tell you immediately if you have
serious foot problems.
Ask your doctor for proper footcare tips. Ask your doctor for the name
of your local podiatrist.
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