Diabetes and Foot Care

For patients with Diabetes, proper foot care is extremely important. Failure to care for the feet can lead to serious health issues and even amputation. How does diabetes and foot care relate? On April 27th, the ABC staff learned more about diabetes and the implications of foot care for diabetics and what to watch for.

Amazing Statistics
There are approximately 17.9 million people in the US with diabetes, and another 57 million people are pre-diabetic. Each year 1.6 million people are diagnosed with this disease. What you might not know is that 50-70% of individuals with this disease lose protective sensation in their feet, meaning they lose the ability to feel pain. This happens because diabetes damages the nerves and reduces blood flow to the feet. Studies have shown that 15% of the individuals that lose protective sensation develop a foot ulcer and one-third of those people require an amputation. Sadly, half of the first time amputees will require a second amputation and 68% of second time amputees die within 5 years.
Given these statistics, it’s great to know there are things you can do to ensure you (or your loved one) take proper care of your feet. Infection in the foot of a diabetic can start with just a small cut, ingrown toenail or sore.

What can you do?
• Inspect the tops and bottoms of your feet each day, perhaps before bed. Choose the same time each day. You can do this with a mirror if it’s difficult to bend over, or enlist the help of a close friend or loved one. Look for cuts, sores or blisters. Check for redness, increased warmth or sensitivity.
• If a cut, bruise, sore or blister found on the bottom of your foot does not begin to heal after one day, consult your doctor.
• If you get a blister, don’t “pop” it. Cover it with a bandage and wear shoes that do not aggravate it.
• Be aware and proactive. Tell your health care provider if your foot changes color, shape, or just feels different (for example, becomes less sensitive or hurts).

Heel Problems:
Cracked heels, also known as heel fissures, are deep cracks in the skin, which are normally caused by excessively dry skin or thick calluses that are typically found at the perimeter of the heel. These are more of a result of lack of attention to the heels rather than over-exposure to the elements or lack of moisture. The cracks are not harmful in any way except when they are deep which tend to become painful and might even begin to bleed. If left untreated, cracked heels may also become infected.

Taking a few extra minutes after a bath or shower can make a big difference in your heels. Start by rubbing pumice stone on heels to loosen the dead skin, followed by applying lanolin or cream of urea to retain moisture in the skin.

While sandals, slingbacks and flip flops are popular in the warmer weather, open back shoes allow the heel to be exposed to the elements as it hangs off the back of the shoe. Try to avoid wearing backless shoes.

Protect your Feet
Do your best to avoid exposure to extreme hot and cold temperatures, which can decrease blood circulation. When that happens, a diabetic might not be able to sense hot or cold adequately.

Doctors & Podiatrists

Diabetics should see a podiatrist (foot doctor) every two to three months for check-ups, even if you don’t have any foot problems. Also, be sure your regular doctor examines your feet during each check-up.

A diabetic should call the doctor if you notice
• Changes in skin color (redness, blackening)
• Changes in skin temperature
• Swelling in your foot or ankle
• Pain in the legs
• Open sores on your feet that are slow to heal or are draining
• Ingrown toenails or toenails infected with fungus
• Corns, calluses or bunions
• Dry cracks in the skin, especially around the heel

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