Diabetes is a disease affecting the whole body. Foot related diabetes complications however, are the major cause of hospital admissions longer than 2 days. With the potential for reduced blood flow, neural and musculature function, the feet are highly susceptible to ulceration which may result in the need for amputation.
Remember the following scary statistics:
- 15% of diabetics will have an ulcer
- 70% of ulcers return within 5 years
- Diabetics are 15 times more likely than non-diabetics to have an amputation.
- 85% of amputations are the result of diabetic ulcers.
Proper care of the feet is therefore essential. This can be achieved by;
- Not smoking
- Eat a healthy low fat diet & maintaining tight control of your blood sugar levels ( it is essential to consult a dietician)
- Exercising regularly (at least 30 minutes 5 times a week). For men aim to have a waist less than 102cm (40 inches) and women a waist of less than 88cm (35 inches).
Correct shoe wear choices
- Avoid walking barefoot, even around the house
- Shoes should be professionally fitted & worn in slowly. When wearing a new set of shoes, only wear them for short periods to begin with. Check your feet after each wear ensuring that there is no redness, blisters or other signs of irritation. Feet swell during the day, so shoes should be tried on in the late afternoon.
- Your feet will widen with age. Therefore have your feet measured every time you buy shoes. Both feet should be measured as they are often different sizes. Always buy shoes for the BIGGEST foot.
- Avoid shoes that have a rough seam or lining on the inside of the shoe.
- If orthotics are worn, take these along to the shoe fitting.
- Avoid synthetic materials such as plastic and synthetic leather as these do not allow the feet to breathe.
- Shoes with laces are preferable to slip-ons.
- Shoes should feel comfortable immediately, there is no such thing as a break in period.
- Shake shoes before putting them on, check lining for tears and foreign objects, such as sticks or stones.
- Slippers should not be used as an all day shoe as they offer no support, they should be used for short periods only. Have two sets of slippers and alternate the days you use them. This prevents tinea. Slippers should be kept beside the bed to wear during the night.
- Rotate between 2-3 pairs of shoes to help prevent tinea.
Socks and Hosiery
- Wearing comfortable socks that are not too tight. i.e. Diabetic socks made of cotton/wool. If the seems of the socks are rough, wear them inside out.
- Never wear stockings/shoes with tight elastic tops as these can restrict circulation
Maintaining foot hygiene
- Inspecting your feet daily, looking for grazes, cuts, sores, scratches, redness, swelling, or any other unusual changes. Feel in-between your toes for any irregularities. If you are unable to see your feet please use a mirror. Please treat foot injuries promptly.
- Washing and drying the foot thoroughly. Always dry between the toes.
- Always cut your toe nails in a well lit area with the right equipment. Make yourself comfortable first and be aware of your limitations, i.e. Bad back, poor eyesight, poor circulation etc.
- Cut the nail according to the curve of the nail. Do not cut down the sides of the nail or use other instruments to probe down the edges.
- File your nails in one direction. You can always file regularly rather than cutting if preferred.
- If you have dry skin on your feet, try sorbolene. If this is not effective then a cream with 10% urea should be tried. If you have a problem with you heels cracking then a visit to your podiatrist is required to decrease the thickened skin and advise you on appropriate treatment. Please don’t put moisturizing creams like sorbolene between your toes.
- When you visit the beach or pool always remember to put sunscreen on your feet and to wear surf shoes.
- See a podiatrist for an annual foot health assessment to help detect any early changes in blood flow or nerve function.
- See a podiatrist on a more frequent basis if you have one of the following:
- nails that are thick, crumbly & discoloured
- Ingrown nails.
- have poor vision or are unable to safely treat feet
- Corns or callus. Please have these seen by a podiatrist, don’t use corn pads.
- history of ulceration
- reduced vascular & nerve function
Care in the winter months
It is important when the weather gets cold to keep your feet well away (3m) from fireplaces and heaters. Never use heating pads, hot water bottles or electric blankets on your feet.
First aid for your feet
Take special care of any wounds on the feet such as minor cuts & blisters. If you sustain a minor injury to the foot follow the following procedure.
- Wash the affected area with warm water or saline
- Pat dry
- Cover with clean dressing
- Check the wound & change dressing daily until it has healed.
- Do not apply antiseptic unless advised by your podiatrist or doctor
If the area becomes red, hot, swollen or smelly contact your doctor for further information.
We strongly suggest you don’t
- Use liquid corn/callus remover, corn pads, wart treatments or razor blades on the feet. We recommend you see us for the removal of corns, callus or warts.
- Attempt to treat ingrown toenails. Please make an appointment to see your podiatrist.