Diabetes

Diabetes is a systemic disease affecting many different parts of the body. Ideal case management requires a team approach. The podiatrist, as an integral part of the multi disciplinary team, has documented success in the prevention of foot amputations. The key to amputation prevention in diabetic patients is early recognition and regular foot screenings, at least annually, by podiatrists.

In addition to these check ups, there are warning signs that one should be aware of so as to seek help as early as possible to prevent foot complications. These include:

• Skin color changes
• Elevation in skin temperature
• 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
• Dry cracks in the skin, especially around the heel

  

If You Have Diabetes Already . . . You must always:

Wash your feet daily.
Using mild soap and lukewarm water. Feet should be washed in the mornings or before bed time on a daily basis. Dry carefully with a soft towel, especially between the toes, and dust your feet with talcum powder to wick away moisture. If the skin is dry, use a good moisturizing cream daily, but avoid any cream between the toes.

Inspect feet and toes daily.
Check your feet every day for cuts, bruises, sores or changes to the toenails, such as thickening or discoloration. If age or other factors inhibit self-inspection, ask someone to help you, or use a mirror.

Wear thick, soft socks.
Socks made of an acrylic blend are well suited, but avoid mended socks or those with seams, which could rub and cause blisters or other skin injuries.

Cut toenails straight across.
Never cut into the corners, or taper, which could trigger an ingrown toenail. Use an emery board to gently file away sharp corners. If your nails are hard to trim, ask your podiatrist for assistance.

See your Podiatrist.
Regular checkups by your podiatrist—at least annually—is the best way to ensure that your feet remain healthy.

Be properly measured and well-fitted by an experienced shoe fitter every time you buy new shoes.
Shoes are of supreme importance to diabetes sufferers because poorly fitted shoes are the cause in as many as half of the problems that lead to amputations. Because foot size and shape may change over time, everyone should have their feet measured by an experienced shoe fitter whenever they buy a new pair of shoes.
New shoes should be comfortable at the time that they are purchased and should not require a "break-in" period, though it’s a good idea to wear them for short periods of time at first. Shoes should have leather or canvas uppers, fit both the length and width of the foot, leave room for toes to wiggle freely, and be cushioned and sturdy.

Don’t go barefoot.
Not even in your own home. Barefoot walking outside is particularly dangerous because of the possibility of cuts, falls and infection. When at home, wear slippers. Never go barefoot.

Don’t wear high heels, sandals, or shoes with pointed toes.
These types of footwear can put undue pressure on parts of the foot and contribute to bone and joint disorders, as well as diabetic ulcerations. In addition, open-toed shoes and sandals with straps between the first two toes should also be avoided.
Don’t wear anything that is too tight around the legs. Panty hose, panty girdles, thigh-highs or knee-highs can constrict circulation to your legs and feet. So can men’s dress socks if the elastic is too tight.

Never try to remove calluses, corns or warts by yourself.
Commercial, over-the-counter preparations that remove warts or corns should be avoided because they can burn the skin and cause irreplaceable damage to the foot of a diabetic patient. Never try to cut calluses with a razor blade or any other instrument because the risk of cutting yourself is too high, and such wounds can often lead to more serious ulcerations and lacerations which could lead to gangrene and amputation.