Diabetic Foot Care

IMPORTANCE OF ROUTINE FOOT CARE
People with diabetes are at higher risk for foot problems. Nerve damage, circulation problems, and infections can cause severe foot problems. Normally, if we injure our foot or an infection occurs, that area of the foot begins to hurt. Complications from diabetes, nerve damage and circulation problems, may cause the pain response not to be recognized by the body. The absence of this pain response may prevent us from recognizing a possibly dangerous condition.

There are several things you can do to try and prevent foot problems before they occur; such conditions such as controlling your blood glucose and not smoking or using any tobacco products. The following provides some additional safeguards against potentially dangerous conditions.

PREVENTION OF FOOT PROBLEMS
The most important thing you can do to prevent serious foot problems is to inspect your feet daily. Wash your feet daily with a mild soap pat dry, do not vigorously rub dry. Use one thickness of the towel to dry between the toes and look for signs of infection, which are redness, sores, drainage or warm to touch. With each inspection observe for the presence of skin changes or deformities. Some of the skin changes could include puncture wounds, blisters, color changes, sores, or drainage. The deformities may include corns or calluses, bunions, hammertoe, ingrown nails or fungus on the nails. Also inspect the pressure points on your feet for any abnormalities. (See illustration of foot for pressure points.) Any of these type of changes should be reported to you health care provider.

Appropriately caring for you toenails will help decrease a common toe infection. Soak or bathe feet before trimming nails. Make sure you trim you nails under good lighting. If your nail is thick see your provider and use a nail file or emery board for trimming. When clipping your nails you should clip them straight across and do not round the edges of nail. You may need special clippers that have a straight cut and not a rounded cut. The nails should extend beyond the skin.

Another vital piece of maintaining healthy feet is having appropriately fitting foot attire. Your shoes should be made of leather or a breathable material. Your shoes should have an adequate cushioned instep support. The shoes should not be too big or too small. If they are too small they will apply pressure to your feet and create blisters and a possible site for an infection. If they are too big your feet will slide within the shoe, creating another source of infection. You should never wear sandals that require a strap to go between your toes.

It is recommended that when purchasing new shoes they should be professionally fitted to your feet. New shoes should be sized in the evenings to allow swelling of your feet. The new shoes should be worn only a few hours for the first couple of days. The shoes should be removed every hour. Inspect your feet for redness or blisters. The shoes should have laces or adjustable closure devices. Laces should be untied before putting on and removing shoes. Assure that the tongue of the shoes is not folded or wrinkled when putting on shoes.

All shoes should be inspected before putting them on to check for seams or objects stuck in the shoe. Put your hand inside of each shoe to check for sharp objects as well as any foreign object within the shoe. Shoes that have pointed toes, high heels, elastic across the tops and plastic/rubber shoes should be avoided.

Be sure to inspect your socks before inserting your foot into the shoe. Avoid wrinkles in your socks, they could create pressure points. Socks that are rough or have large seams should also be avoided. Socks should be clean and dry, changing throughout the day if they become moist. Wear thin, white, cotton socks in the summer with square-toe ends to aid in absorption of moisture and avoid excess pressure on the toes. Individuals with diabetes should never walk barefoot, even within your home. Slippers or sandals should be worn to prevent injuries to the soles of your feet.

Additional steps to prevent an injury or infection to your feet are to protect your feet from extreme temperatures. With the decreased sensation to your feet you are more likely to receive burns or blister from extreme heat or frost bite with the cold. If you should notice that your feet are excessively dry, you should apply a lotion to them at least daily, but avoid applying lotion between your toes. If you feet are overly moist, apply a powder to your feet and shoes to absorb excess moisture. Never use a heating pad on your feet. Do not place your feet on a radiator, furnace or hot water pipes. Do not put your feet in front of a fireplace or heater. Never use a hair dryer on your feet. Finally, try to avoid sitting cross-legged this decreases blood flow to and from the feet.

The final thing you can do to prevent foot problems associated with diabetes, is to remove your shoes and socks at each and every appointment with your provider. This action will remind the provider to inspect your feet and make recommendations on the care of your feet.

Problems to report to your provider

• Pain in feet or legs
• Cuts or scratches that don’t heal
• Cold or pale skin
• Puffiness or discoloration
• Dried or cracked skin
• Redness
• Warm/hot to touch
• Sores on feet
• Numbness or tingling
• Any areas of concern

McKinley Health Center does offer Disease Management for most chronic health conditions including diabetes. Please call and schedule an appointment if you have any questions or concerns.

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