Amputation PRevention
Diabetes is a disease of inability of the body to naturally control sugar balances. Insulin and other factors allows sugars to be taken from the blood and into tissues where it can be broken down and used for energy. Diabetes can be caused by the bodies inability to produce insulin or the bodies resistance to the insulin present. Because of this lack of ability to take sugar from the blood stream an into the tissues this can cause and excess of sugars which are thought to become deposited causing and contributing to problems such as neuropathy, nephropathy (kidney disease), vision abnormalities such as glaucoma, and vascular disease.
These factors can lead to inability to detect pain and excessive pressure causing wounds, decreased blood flow to heal the wounds, decrease white blood cell function to fight bacteria and infections, and decreased vision to detect when a wound has occurred.
The diabetic foot can be especially fragile. Diabetes can affect the body and foot in multiple ways. People with diabetes are much more likely to have: 1-loss of protective sensation or neuropathy. 2-Decreased blood flow to the feet and legs. 3-Decreased ability to see and or inspect their feet.
"Small" incidents such as calluses, ingrown or painful toenails, small wounds, inappropriate shoe gear, going barefoot, stepping on unknown objects may all seem like minor items but because of the multi factorial effect of diabetes these can become situations severe infections that cause loss of limb or life.
The following are recommendations by Dr. Oaks that can contribute to better foot care and overall health.
Persons with diabetes must learn to take special notice of even the most minor foot problems. In those diabetic individuals with poor circulation or loss of feeling in the feet, even trivial injuries may result in serious consequences. First and foremost under the direction of your endocrinologist, family practitioner, or internist control your blood sugar levels by recommended monitoring and following diabetic medication instructions.
1. Do not smoke.
2. Wash feet daily with soap and water and dry carefully between the toes.
3. Do not take a bath or soak your feet until the temperature of the water has been tested. The water should be tepid. If you do not have good feeling in your hand, ask someone who is not a diabetic to test the water temperature for you.
4. Use moisturizing creams or ointments for dry skin. Prevent cracking of the skin.
5. Do not walk barefoot, especially around swimming pools and beaches. A slipper with a good sole is helpful in the house.
6. Wear shoes with a soft upper which fit properly. Do not depend on them to "stretch out". For some persons with diabetes, special footwear may be needed. Break new shoes in gradually.
7. Do not put your shoes on until you have inspected the inside for wrinkles, sharp nails coming through the sole, or other objects which create undue pressure on the skin.
8. Examine your feet when you remove your shoes for possible areas of irritation or injury. If your vision is poor have someone else examine your feet. What you see is often more important than what you feel!
9. Do not use electric heating pads or hot water bottles on your feet. If necessary, use loose warm bed socks instead.
10. Do not cut your corns and calluses, and do not use commercial corn and callus pads which are medicated.
11. Cut nails straight across. Ask your podiatrist if it is a good idea to cut your own nails.
12. Consult your podiatrist or family physician if you notice any redness, swelling, blistering, ingrown nails, corns, calluses, or other irregularities.
13. The American Diabetic Association recommends at least annual foot check-ups for all persons with diabetes. Those with documented neuropathy or vascular disease should be seen bi-annually (with ulceration/amputation history quarterly). Your doctor can assess your risk for future problems and help you avoid them.
Remember, diabetic persons often have special problems with their feet. Reasonable measures and precautions to avoid foot injuries will help a great deal in minimizing the risk of avoidable complications.
These factors can lead to inability to detect pain and excessive pressure causing wounds, decreased blood flow to heal the wounds, decrease white blood cell function to fight bacteria and infections, and decreased vision to detect when a wound has occurred.
The diabetic foot can be especially fragile. Diabetes can affect the body and foot in multiple ways. People with diabetes are much more likely to have: 1-loss of protective sensation or neuropathy. 2-Decreased blood flow to the feet and legs. 3-Decreased ability to see and or inspect their feet.
"Small" incidents such as calluses, ingrown or painful toenails, small wounds, inappropriate shoe gear, going barefoot, stepping on unknown objects may all seem like minor items but because of the multi factorial effect of diabetes these can become situations severe infections that cause loss of limb or life.
The following are recommendations by Dr. Oaks that can contribute to better foot care and overall health.
Persons with diabetes must learn to take special notice of even the most minor foot problems. In those diabetic individuals with poor circulation or loss of feeling in the feet, even trivial injuries may result in serious consequences. First and foremost under the direction of your endocrinologist, family practitioner, or internist control your blood sugar levels by recommended monitoring and following diabetic medication instructions.
1. Do not smoke.
2. Wash feet daily with soap and water and dry carefully between the toes.
3. Do not take a bath or soak your feet until the temperature of the water has been tested. The water should be tepid. If you do not have good feeling in your hand, ask someone who is not a diabetic to test the water temperature for you.
4. Use moisturizing creams or ointments for dry skin. Prevent cracking of the skin.
5. Do not walk barefoot, especially around swimming pools and beaches. A slipper with a good sole is helpful in the house.
6. Wear shoes with a soft upper which fit properly. Do not depend on them to "stretch out". For some persons with diabetes, special footwear may be needed. Break new shoes in gradually.
7. Do not put your shoes on until you have inspected the inside for wrinkles, sharp nails coming through the sole, or other objects which create undue pressure on the skin.
8. Examine your feet when you remove your shoes for possible areas of irritation or injury. If your vision is poor have someone else examine your feet. What you see is often more important than what you feel!
9. Do not use electric heating pads or hot water bottles on your feet. If necessary, use loose warm bed socks instead.
10. Do not cut your corns and calluses, and do not use commercial corn and callus pads which are medicated.
11. Cut nails straight across. Ask your podiatrist if it is a good idea to cut your own nails.
12. Consult your podiatrist or family physician if you notice any redness, swelling, blistering, ingrown nails, corns, calluses, or other irregularities.
13. The American Diabetic Association recommends at least annual foot check-ups for all persons with diabetes. Those with documented neuropathy or vascular disease should be seen bi-annually (with ulceration/amputation history quarterly). Your doctor can assess your risk for future problems and help you avoid them.
Remember, diabetic persons often have special problems with their feet. Reasonable measures and precautions to avoid foot injuries will help a great deal in minimizing the risk of avoidable complications.