Diabetic Foot Care
WHAT IS DIABETES?
Diabetes is the inability to manufacture or properly use insulin, and it impairs the body’s ability to convert sugars, starches, and other foods into energy. The long-term effects of elevated blood sugar (hyperglycemia) can lead to serious damage to the eyes, heart, kidney, nerves, and feet. Diabetes affects the lives of nearly 26 million people in the United States, and nearly seven million don’t even know they have the disease yet!
While there is no cure for diabetes, there is hope. With proper diet, exercise, medical care, and careful management at home, a person with diabetes can avoid the most serious complications and enjoy a full and active life. Podiatrists play a key role in helping patients manage diabetes successfully and avoid foot-related complications.
SYMPTOMS
- Skin color changes
- Swelling of the foot or ankle
- Pain in the legs
- Open sores on the feet that are slow to heal
- Ingrown and fungal toenails
- Bleeding corns and calluses
CARING FOR YOUR FEET
If you have diabetes, follow these foot care tips:
- Inspect feet daily. Check your feet and toes every day for cuts, bruises, sores, or changes to the toenails, such as thickening or discoloration.
- Wear thick, soft socks. Avoid socks with seams, which could rub and cause blisters or other skin injuries.
- Exercise. Walking can keep weight down and improve circulation. Be sure to wear appropriate athletic shoes when exercising.
If you have diabetes, follow these foot care tips:
- Have new shoes properly measured and fitted. Foot size and shape may change over time. Shoes that fit properly are important to those with diabetes.
- Don’t go barefoot. Don’t go without shoes, even in your own home. The risk of cuts and infection is too great for those with diabetes.
- Never try to remove calluses, corns, or warts by yourself. Over-the-counter products can burn the skin and cause irreparable damage to the foot for people with diabetes.
- See your podiatrist. Regular checkups by a podiatrist are the best way to ensure that your feet remain healthy. Checkups should be scheduled annually or more frequently if needed.
A diabetic foot ulcer is an open sore or wound that occurs in approximately 15 percent of patients with diabetes and is commonly located on the bottom of the foot. Of those who develop a foot ulcer, 6 percent will be hospitalized due to infection or other ulcer-related complication.
Anyone who has diabetes can develop a foot ulcer.People who use insulin are at higher risk of developing a foot ulcer, as are patients with diabetes-related kidney, eye, and heart disease. Being overweight and using alcohol and tobacco also play a role in the development of foot ulcers.
Ulcers form due to a combination of factors, such as lack of feeling in the foot, poor circulation, foot deformities, irritation (such as friction or pressure), and trauma, as well as duration of diabetes. Patients who have diabetes for many years can develop neuropathy, a reduced or complete lack of ability to feel pain in the feet due to nerve damage caused by elevated blood glucose levels over time. The nerve damage often can occur without pain, and one may not even be aware of the problem. Your podiatrist can test feet for neuropathy with a simple, painless tool called a monofilament.
Once an ulcer is noticed, seek podiatric medical care immediately. Foot ulcers in patients with diabetes should be treated to reduce the risk of infection and amputation, improve function and quality of life, and reduce health-care costs.
For optimum healing ulcers on the bottom of the foot must be “off-loaded.” You may be asked to wear special footgear, or a brace, specialized castings, or use a wheelchair or crutches. These devices will reduce the pressure and irritation to the area with the ulcer and help to speed the healing process.
Appropriate wound management includes the use of dressings and topically-applied medications. Products range from normal saline to growth factors, ulcer dressings, and skin substitutes that have been shown to be highly effective in healing foot ulcers. For a wound to heal there must be adequate circulation to the ulcerated area. Your podiatrist can determine circulation levels with noninvasive tests.
Tightly controlling blood glucose is of the utmost importance during the treatment of a diabetic foot ulcer. Working closely with a medical doctor or endocrinologist to control blood glucose will enhance healing and reduce the risk of complications.