Yesterday was our presentation to the Forsyth Presbyterian Church Diabetic Support Group on foot care for diabetics. We had a great time and a wonderful audience! We presented an informative powerpoint on topics related to diabetic foot issues and care. After the presentation, we opened up the floor to questions from the group. They had such great questions and we were glad to provide answers. They allowed us to introduce our business and asked about our business services.
Diabetics have to really focus on care of the feet due to issues such as neuropathy and poor circulation. These problems can lead to injury,damage to the feet and major infections. The numbness can mask issues that the diabetic needs to be aware of such as cuts and breaks in the skin. Any damage to the skin is a potential infection waiting to happen. Poor circulation only hampers the healing process and leaves the wound vulnerable to increased chance of infection. This can lead to long term wound care and worst case scenario, amputation.
Learning how to prevent foot problems is the best approach to foot care of the diabetic. If wounds or damage occur, one must learn proper guidelines for making the quickest recovery and ways to heal to avoid a long healing process or amputation.
Below you will find highlights of our handout that was presented to the group. It also includes some good advice on when to call a doctor so that the healing process can begin as quickly as possible. Hope you find this information valuable.
DIABETES AND FOOT PROBLEMS
For those with diabetes, the increased sugar (glucose) in their blood for long periods of time can lead to serious health complications. These complications affect all parts of the body to include the foot. It is important to pay attention to the foot of the diabetic and to take regular care of the feet and toenails. This handout is designed as a guide for regular foot care and suggestions for better foot health. As always, if complications arise, see your physician for medical guidance and care.
How does diabetes affect the foot?
Diabetic neuropathy: A person with uncontrolled diabetes over time can lead to nerve damage. If those nerves are in ones feet and legs it can lead to lack of feeling and pain. If one cannot feel pain or temperature in their feet, the foot can become damaged without the person even knowing about the sore. This can lead to infection and worsening of the damage and in worst case can lead to amputation. If the muscles are not working properly in the legs due to nerve damage, the legs and feet may not align properly. This can lead to increased pressure in one area of the foot. This increased pressure can lead to aggravating calluses and pressure sores.
Peripheral vascular disease: Diabetes affects the flow of blood. When the flow of blood is affected in the vessels away from the heart, it is called peripheral vascular disease. This circulation disorder results in poor blood flow and leads to poor healing of wounds. If an infection or wound cannot heal properly, the person is at risk for ulcers or gangrene.
Common foot problems with diabetes
Anyone can get these foot problems but for the diabetic, they are much more complicated. These problems can lead to infection and serious complications, such as amputation.
Athlete's foot: This is a fungal infection that causes itching, redness and cracking of the skin on the feet. If left unmanaged, it can lead to infection in the cracks and breaks in the skin.
Fungus of the toe nails: This is recognized by the yellowing and thickening of the nails. Injury to the nail as well as environment can lead to fungal infection. If left untreated it can lead to damage to the tissue under the nail and lead to infection.
Calluses: A build up of thick skin. They can be caused by uneven wear on the foot or improper fitting shoes. If the buildup becomes too thick, sores and infection can occur under the callous. Calluses can also be painful if they are allowed to build up out of control.
Corns: This is a buildup of hard skin near a bone of the foot or toe. It can also occur between toes. They are a result of pressure and friction from shoes or toes rubbing together. Corns are painful and can lead to an open sore if untreated.
Blisters: These form when the shoe rubs the same spot on the foot. The leading cause is improper fitting shoes. Open damaged skin from a blister is an easy target for infection.
Bunions: These form when the big or great toe angles in toward the second toe. When this occurs, the joint where the big toe meets the foot can become irritated and sore. At times calluses form there. This area of increased friction and pressure can get irritated to the point of damage and open tissue, which can lead to infection.
Dry skin: This can cause breaks in the skin which can allow entry of germs and cause infection.
Foot ulcers: This is a break in the skin that leads to a deep sore. These can result from small scrapes or cuts that do not heal properly. Left untreated they can worsen in depth and become severely infected.
Hammertoes: This is a toe that is bent due to a weakened muscle. The weakened muscle causes the tendon to shorten which leads to the toe curling under the feet to varying degrees. These can lead to ill fit in the shoe which can cause damage to tissues and lead to infection.
Ingrown toenails: This occurs when the edge of the toenail grows into the skin. This can cause pressure and pain and even lead to cuts into the skin. Left untreated, they can be a source of infection.
Plantar warts: These warts look like small calluses on the ball of the foot or heel. These are usually painful and can form singly or in clusters. Do not attempt to remove them with over the counter medications. It is highly recommended to seek medical treatment of these warts so as to avoid risk of damage and infection.
All these aforementioned foot problems or complications can be treated and it is advised for the diabetic to seek medical advice in treating these issues.
Here are some tips for preventing these common problems and treating them before they become serious:
Make sure you take care of yourself and your diabetes. This includes following your physician's advice in relation to nutrition, exercise, and medication.
Monitor and keep your blood sugar within a desired range as recommended by your physician.
Wash feet daily in warm water using mild soap. Be sure to test the water with your elbow remembering that nerve damage can affect fingers and toes. This can cause false temperature readings when testing water.
Do not soak your feet as this can be drying. Be sure to dry your feet well, especially between toes.
CHECK FEET DAILY for sores, blisters, redness, calluses, or any other complications listed previously. If you cannot check them yourself, have a significant other, friend or caregiver.
If skin on feet is dry, use lotion after daily foot care. Keep lotion out of between toes as this can lead to bacterial growth. Ask your physician for the best type of foot lotion to use.
Smooth corns and calluses with an emery board or pumice stone gently. It is best to do after foot care when skin is soft. Use the emery board in only one direction.
Check toenails 1x per week. Trim nails as needed. Trim straight across and avoid cutting down the sides of the nail. If possible, have professional care done to nails.
Wear closed toe shoes or slippers. It is best to not wear sandals or walk barefoot, even in the house.
Always wear socks or stockings that are not binding.
Wear well fitted shoes. Use shoes made for diabetics if possible.
Always check inside of shoe for objects that can damage foot if not seen.
Protect feet from hot or cold.
Keep blood flow to your feet by elevating feet while sitting, wiggle toes and ankles several times a day, and do not cross your legs for long periods of time.
STOP SMOKING. Smoking leads to decreased blood flow.
If a foot problem is identified, gets worse or won't heal, seek medical advice and treatment.
Make sure your diabetic doctor examines your feet at each visit. An annual exam should be completed that includes inspection of skin, a check of temperature of feet and an assessment of the sensation of the foot.
WHEN TO CONTACT DOCTOR
Changes in skin color
Changes in skin temperature
Swelling in foot or ankle
Pain in legs
Open sores on the feet that are slow to heal or draining
Ingrown toenails or nails with fungal infection
Corns or calluses
Dry cracks in the skin
Unusual or persistent foot odor.