Foot problems can be directly caused by diabetes. They can also be secondaryto some of the effects of diabetes on the feet. These effects most commonlyinclude loss of circulation and loss of feeling. A person with diabetes shouldfollow guidelines for good foot care to prevent unnecessary complications.
What is the information for this topic?
A person with diabetes often has peripheralvascular disease, or decreased circulation to the legs and feet.Anydamage to the feet may heal slowly because of the poor circulation. The personmay also have diabeticneuropathy, inwhich nerve damage from diabetes causes decreased sensation in the legs andfeet. The person can develop an open area from pressure or from a cut, and noteven feel the sore. Untreated, the damaged area can develop a diabetic foot ulcer.
The following factors increase a person’s chance of developing a foot ulcer:
diabetic neuropathy,with damageto the nerves supplying the feet
peripheral vasculardisease, withdecreased blood flow to the feet
a history of 10 years or more of diabetes
blood sugar levelsthat are notunder control
diabetic retinopathy, ordamage tothe retina of the eye caused by diabetes
cardiovascular problems caused by diabetes
kidney problems caused by diabetes, including chronic renalfailure
a history of skin ulcers or amputation of a limb
conditions caused by increased pressure on the feet, such as corns andcalluses
foot bones that are deformed or have limited movement, such as bunions
Guidelines for preventing foot ulcers from diabetes
Inspect the feet daily for blisters, cuts, scratches, scalings,discolorations, and unusual swelling of the feet or toes. Pay particularattention to the area between the toes. If vision is poor or if reaching the feet isdifficult, a member of the family should assist.
Clean and soak both feet in tepid water for 15 minutes before trimmingtoenails.
Trim toenails so they are even with the end of the toe, and file sharp edges smooth.Corners should never be cut or dug out.
See a healthcare professional if the nails grow into the flesh or if they aredifficult to cut.
Wash feet daily with warm water and mild soap. Dry feet completely,especially between the toes.
Gently massage a bland lubricating cream into the feet after drying them,especially around the toenails and heels. Do not put creams or ointmentsbetween the toes. Dust a non-medicated powder between the toes.
Never use strong antiseptics, especially tincture of iodine, disinfectants, orbleaching agents, on the feet.
If a cut is present, wash the area with an antibacterial soap. After dryingthe area, apply an antibiotic ointment and cover it with a steriledressing.
Avoid extremes of temperature. Protect feet from sunburn and frostbite.
Wear clean cotton or wool socks to bed if feet are cold. Hot water bottlesor heating pads should not be used.
Change socks and stockings daily. Circular garters or stockings withelastic at the top should not be worn. They may cause a tourniquet effect thatwill lead to swelling of the lower leg.
Wear properly fitted shoes with soft uppers and flexible soles, preferablywith adjustable straps or laces. Avoid walking barefoot or wearingopen-toed or open-heeled shoes.
Break new shoes in gradually, by wearing them for a short time each day.Check inside shoes daily for foreign objects, nail points,and torn linings. If the linings are torn or crumpled, the shoe should bediscarded.
Corns or calluses should be treated by a healthcare professional. Never cutthem with a razor blade or use chemicals to remove them.
Monitoring by the healthcare professional
On each visit, the healthcare professional should specifically ask aboutany foot problems or leg or foot pain when the person is sitting, standing, orwalking.
The healthcare professional should check the pulse in the groin, behind theknees, behind the anklebones, and on top of the feet. He or she should listenwith a stethoscope to the blood vessels in the legs.
The healthcare professional should test the person’s ability to feel sharpand dull sensations, vibrations, and light touches to the feet and toes.
The healthcare professional should look for corns, calluses, deformities,cuts, bruises, bunions,diabetic foot ulcers, andinfections.
Approximately 50% to 70% of foot amputations among people with diabetes could be prevented if foot problems are identified early andproperly treated.
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