The Diabetic Foot
Definition
Diabetes is a serious disease that can develop
from lack of insulin production in the body or due to the
inability of the body's insulin to perform its normal everyday
functions. Insulin is a substance produced by the pancreas gland
that helps process the food we eat and turn it into energy.
Diabetes affects approximately 16 million
Americans and is classified into 2 different types: Type 1 and
Type 2. Type 1 is usually associated with juvenile diabetes and
is often linked to heredity. Type 2, commonly referred to as
adult onset diabetes, is characterized by elevated blood sugars,
often in people who are overweight or have not attended to their
diet properly.
Many complications can be associated with
diabetes. Diabetes disrupts the vascular system, affecting many
areas of the body such as the eyes, kidneys, legs, and feet.
People with diabetes should pay special attention to their feet.
Cause
Neuropathy
Of the sixteen million Americans with
diabetes, 25% will develop foot problems related to the disease.
Diabetic foot conditions develop from a combination of causes
including poor circulation and neuropathy. Diabetic Neuropathy
can cause insensitivity or a loss of ability to feel pain, heat,
and cold. Diabetics suffering from neuropathy can develop minor
cuts, scrapes, blisters, or pressure sores that they may not be
aware of due to the insensitivity. If these minor injuries are
left untreated, complications may result and lead to ulceration
and possibly even amputation. Neuropathy can also cause
deformities such as Bunions, Hammer Toes, and Charcot Feet.
It is very important for diabetics to take the
necessary precautions to prevent all foot related injuries. Due
to the consequences of neuropathy, daily observation of the feet
is critical. When a diabetic patient takes the necessary
preventative footcare measures, he or she reduces the risks of
serious foot conditions.
Poor
Circulation
Diabetes often leads to peripheral vascular
disease that inhibits a person’s blood circulation. With this
condition, there is a narrowing of the arteries that frequently
leads to significantly decreased circulation in the lower part
of the legs and the feet. Poor circulation contributes to
diabetic foot problems by reducing the amount of oxygen and
nutrition supplied to the skin and other tissue, causing
injuries to heal poorly. Poor circulation can also lead to
swelling and dryness of the foot. Preventing foot complications
is more critical for the diabetic patient because poor
circulation impairs the healing process and can lead to ulcers,
infection, and other serious foot conditions.
Treatment and Prevention
Footwear and orthotics play an important role
in diabetic footcare. Orthotics designed with Plastazote“ foam,
the #1 material for protecting the insensitive diabetic foot,
are usually recommended. Plastazote is a material designed to
accommodate pressure “hot spots” by conforming to heat and
pressure. By customizing to the foot, Plastazote provides the
comfort and protection needed in diabetic footcare. Footwear
constructed with Plastazote is also recommended frequently for
the diabetic patient. Diabetic footwear should also provide the
following protective benefits:
- High, wide toe box (high and wide space in
the toe area)
- Removable insoles for fitting flexibility
and the option to insert orthotics if necessary.
- Rocker Soles designed to reduce pressure in
the areas of the foot most susceptible to pain, most notably
the ball-of-the-foot.
- Firm Heel Counters for support and
stability.
If you are a diabetic, you should be
particularly alert to any problems you may be having with your
feet. It is very important for diabetics with neuropathy to take
necessary precautions to prevent injury and keep their feet
healthy. If you have diabetes and are experiencing a foot
problem, immediately consult your foot doctor.
Footcare
& Diabetes
Proper footcare is especially critical for
diabetics because they are prone to foot problems such as:
- Loss of feeling in their feet
- Changes in the shape of their feet
- Foot ulcers or sores that do not heal
Simple daily footcare can prevent serious
problems. According to the National Institute of Health, the
following simple everyday steps will help prevent serious
complications from diabetes:
- Take Care of Your Diabetes
Make healthy lifestyle choices to keep your blood sugar close
to normal. Work with your health care team to create a
diabetes plan that fits your lifestyle characteristics.
- Check Your Feet Every Day
You may have foot problems that you may not be aware of. Check
your feet for cuts, sores, red spots, swelling, or infected
toenails. Checking your feet should become part of your daily
routine. If you have trouble bending over to see your feet,
use a plastic mirror to help. You can also ask a family member
to help you.
Important Reminder Be sure to call your doctor immediately
if a cut, sore, blister, or bruise on your foot does not heal
after one day.
- Wash Your Feet Every Day
Wash your feet in warm, NOT HOT, water. Do not soak your feet
because your skin will get dry. Before bathing or showering,
test the water to make sure it is not too hot. You should use
a thermometer or your elbow. Dry your feet well. Be sure to
dry between your toes. Use talcum powder to keep the skin dry
between the toes.
- Keep the Skin Soft and Smooth
Rub a thin coat of skin lotion or cream on the tops and
bottoms of the feet. Do not put lotion between your toes,
because this might cause infection.
- Trim your Toenails Each Week
or When Needed
Trim your toenails with clippers after you wash and dry your
feet. Trim the toenails straight across and smooth them with
an emery board or nail file. DO NOT cut into the corners of
the nail or rip off hangnails. If your nails are thick or
yellowed, DO NOT cut your own nails; have a foot doctor trim
them.
- Wear Shoes and Socks At All
Times
Wear shoes and socks at all times. Do not walk barefoot, not
even indoors. It is extremely easy to step on something and
hurt your feet. Always wear seamless socks, stockings, and
nylons with your shoes to help avoid the possibility of
blisters and sores developing. Be sure to choose seamless
socks that are made of materials that wick moisture away from
your feet and absorb shock and shear. Socks made of these
materials help keep your feet dry. Always check the insides of
your shoes before putting them on. Make sure the lining is
smooth and there are no foreign objects in the shoe, such as
pebbles. Wear shoes that fit well and protect your feet.
- Protect Your Feet From Hot and
Cold
Always wear shoes at the beach or on hot pavement. Put
sunscreen on the tops of your feet for protection from the
sun. Keep your feet away from radiators or open fires. DO NOT
use hot water bottle or heating pads on your feet. If your
feet are cold, wear seamless socks at night. Lined boots are
good to keep your feet warm in the winter. Choose socks
carefully. DO NOT wear socks with seams or bumpy areas. Choose
padded socks to protect your feet and make walking more
comfortable. In cold weather, check your feet often to keep
your feet warm avoid frostbite.
- Keep the Blood Flowing to Your
Feet
Put your feet up when you are sitting. Wiggle your toes for 5
minutes, 2 or 3 times a day. Move your ankles up and down and
in and out to improve blood flow in your feet and legs.
- DO NOT cross your legs for long periods
of time.
- DO NOT wear tight socks, elastic, or
rubber bands, or garters around your legs.
- DO NOT wear restrictive footwear or foot
products. Foot products that can cut off circulation to the
feet, such as products with elastic, should not be worn by
diabetics.
- DO NOT smoke. Smoking reduces blood flow
to your feet.
If you have high blood pressure or high cholesterol, work
with your health care team to lower it.
- Be More Active
Ask your doctor to plan an exercise program that is right for
you. Walking, dancing, swimming, and bicycling are good forms
of exercise that are easy on the feet. Avoid all activities
that are hard on the feet, such as running and jumping. Always
include a short warm-up or cool-down period. Wear protective
walking or athletic shoes that fit well and offer good
support.
- Communicate With Your Doctor
Ask your doctor to check the sense of feeling and pulses in
your feet at least once a year. Ask your doctor to tell you
immediately if you have serious foot problems. Ask your doctor
for proper footcare tips and for the name of your local
podiatrist.
Foot
Health
Information Provided By:
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