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Dr. Adebimpe Alere
Obafemi Awolowo Univ Teaching Hospital

Ile Ife, Osun, Nigeria
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CARE OF THE DIABETIC FOOT.
by Adebimpe Alere

 

A small cut can produce deleterious consequences. Diabetes may cause nerve damage that takes away  the sensation in your feet. Diabetes may also reduce blood flow to the feet, making it difficult for an injury to heal or to resist infection.

Diabetes mellitus (DM) represents several diseases in which high blood sugar (glucose) levels over time can damage the nerves, blood vessels, kidneys and eyes. Diabetic foot is an umbrella term for foot problems in patients with diabetes. Diabetes can be dangerous to your feet. Foot problems commonly develop in people with diabetes and can quickly become life threatening. Ten to fifteen percent of diabetic patients develop foot ulcers at some point in their lives, and foot related problems are responsible for up to fifty percent of diabetes-related hospital admissions.

 

A small cut can produce deleterious consequences. Diabetes may cause nerve damage that   takes away  the sensation in your feet. Diabetes may also reduce blood flow to the feet, making it difficult for an injury to heal or to resist infection. Due to these problems, one may not notice a foreign object in the shoe and as a result you could develop a blister or a sore which may not be felt because of damage to your nerves. This could lead to an infection or a non-healing wound that could put you at risk for an amputation. Surprisingly, up to eighty-four percent of leg amputations are preceded by an ulcer. Amputation is preventable via good care. Good care  saves the legs.

Therefore, people with diabetes need to learn how to recognize the early signs and symptoms of foot problems. These include decreased sensation in the feet, changes  in the contour of one or both feet; a sensation of walking on a carpet while walking on bare floor, persistent pain in the foot joints, pain in the legs or buttocks that increases with walking and improves with rest; hairlesslegs and feet, hard shiny skin on feet; bruises and sores. One should be aware of the difference in the need for home foot care, when to call the doctor and when a problem has become dangerous enough to seek emergency treatment.

In view of all these:

Inspect your feet daily. Check for cuts, blisters, redness, swelling, or nail problems. Use a magnifying hand mirror to look at the bottom of your feet. Call your doctor if you notice anything.

Wash your feet in lukewarm (not hot!) water. Keep your feet clean by washing them daily. Use only lukewarm water – the temperature you would use on a newborn baby.

Be gentle when bathing your feet. Wash them using a soft washcloth or sponge. Dry by blotting or patting, and carefully dry the area between the toes.

Moisturize your feet – but not between your toes. Use a moisturizer daily to keep dry skin from itching or cracking (especially the harmattan season for Nigerians), but DON’T moisturize between the toes – that could encourage a fungal infection.

Cut nails carefully. Cut them straight across and file the edges. Don’t cut nails too short, as this could lead to ingrown toe nails. If you have concerns about your nails, consult your doctor.

Never treat corns or calluses yourself. No “bathroom surgery” or medicated pads. Visit your doctor for appropriate treatment.

Wear clean, dry socks. Change them daily.

Avoid the wrong type of socks. Avoid tight elastic bands (they reduce circulation). Don’t wear thick or bulky socks (they can fit poorly and irritate the skin).

Wear socks to bed. If your feet get cold at night, wear socks. NEVER use a heating pad or hot water bottle.

Shake out your shoes and feel the inside before wearing. Remember, due to diminished sensation in your feet, your feet may not be able to feel a pebble ,pin  or other foreign object, so always inspect your shoes before putting them on.

Keep your feet warm and dry. Don’t let your feet get wet in snow or rain. Wear warm socks and shoes in winter.

Never walk barefoot. Not even at home! Always wear soft shoes or slippers. You could step on something and get a scratch or cut.

Take care of your diabetes. Keep your blood sugar level under control. (comply with your physician’s instructions and medication)

Don’t smoke. Smoking restricts blood flow in your feet.

Get periodic foot exams. Seeing your foot and ankle surgeon on a regular basis can help prevent the foot complications of diabetes.

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