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Diabetics and Foot Care

What Is It?

Diabetes mellitus refers to a group of diseases that affect how your body uses blood glucose, commonly called blood sugar. Insulin is a hormone that helps the body deal with the blood sugar in your diet. When diabetes is present, either the body produces less or no insulin (Type 1) or the body tissues are resistant to the effects of diabetes (Type 2). This results in higher levels of glucose in the blood, which can damage a whole range of body tissues, muscles and organs.

Potentially reversible diabetic conditions include pre-diabetes, when your blood sugar levels are higher than normal, but not high enough to be classified as diabetes and gestational diabetes, which occurs during pregnancy.

Diabetes generally decreases the body’s ability to fight infection. When diabetes is not well controlled, damage to the organs and impairment of the immune system (nerves, kidneys, eyes, and blood vessels) is likely. Foot problems commonly develop in persons with diabetes and can quickly become serious.

Symptoms

Varying symptoms occur and is basically dependent on the type of diabetes one has. There are certain symptoms that persons with pre-diabetes or gestational diabetes may not experience. Others, however, might experience some or all of the symptoms of Type 1 and Type 2 diabetes:

  • Increase in thirst
  • Greater frequency in urinating
  • Extreme hunger
  • Weight loss
  • Fatigue
  • Blurred vision
  • Ulcers (sores) – slow healing
  • Frequent infections.

Diabetic Foot Care Causes

Several risk factors increase a diabetic’s chances of developing foot problems and infections in the legs and feet.

  • Footwear

Poorly fitting shoes are a frequent cause of diabetic foot problems. If the patient has red spots, sore spots, blisters, corns, calluses, or consistent pain associated with wearing shoes, new properly fitting footwear must be obtained as soon as possible. If the patient has common foot abnormalities such as flat feet, bunions, or hammertoes, prescription shoes or arch supports may be necessary.

  • Weight

 The more fatty tissue you have, the more resistant your cells become to insulin.

  • Inactivity

The less active you are, the greater your risk. Physical activity helps you control your weight, uses up glucose as energy, and makes your cells more sensitive to insulin.

  • Nerve damage

People with long-standing or poorly controlled diabetes are more prone to having damage to the nerves in their feet. The medical term for this is peripheral neuropathy. Because of the nerve damage, the patient may not be able to feel their feet normally. Also, they may be unable to sense the position of their feet and toes while walking and balancing. Usually people can sense if their shoes are rubbing their feet, or if one part of the foot is becoming strained while walking.

A person with diabetes may not properly sense minor injuries (such as cuts, scrapes, blisters), signs of abnormal wear and tear (that turn into calluses and corns), and foot strain. Normally, people can feel if there is a stone in their shoe, then remove it immediately. A person who has diabetes may not be able to perceive a stone; and its constant rubbing can easily create a sore.

  • Poor circulation

Diabetes can lead to accelerated hardening of the arteries, especially when poorly controlled. When blood flow to injured tissues is poor, healing does not occur properly.

  • Infections

Athlete’s foot, a fungal infection of the skin, can lead to more serious bacterial infections and should be treated promptly. Toenail fungus, ingrown toenails and foot ulcers should be treated right away by a foot specialist.

  • Smoking

Smoking any form of tobacco causes damage to the small blood vessels in the feet and legs. This damage can disrupt the healing process and is a major risk factor for infections and amputations. The importance of ceasing smoking is key.

Do’s and Don’ts

To prevent problems from developing:

1.      Wash your feet daily using lukewarm water.

2.      Dry the feet very carefully, especially between the toes. If the skin is dry, use a good   moisturizing cream but not between the toes.

3.      Inspect your feet daily (check for sores, cuts, bruise, changes to the toenails; use a    mirror to look under the foot if you can not see it).

4.      Look after your health (lose weight if needed; stop smoking; exercise; reduce your alcohol consumption).

    1. Cut toenails straight across and never cut into the corners; use an emery board or file on sharp corners.
    2. Do not try to remove corns, plantar warts (fish eyes) or calluses yourself, see a Specialist for this.
    3. Never use commercial corn cures – this is so important in those with diabetes as it is very easy to damage the skin with the acid in these products.
    4. Avoid going barefoot; even in your own home (this lessens the chance of some accidental damage).
    5. Ensure new shoes are comfortable when purchased; they should not need a “break-in” period.
    6. Check your doctor regularly to ensure all is well.

Diabetes and pedicures: Do they go together?

Unless specified by a doctor you can do pedicures once the pedicurist is trained to handle such.

  • Use good judgment. Be picky about where you choose to go. Enquire at several places and confirm that they are properly trained.
  • Inspect the foot tub. Does it get cleaned between clients?
  • Don’t be afraid to give instructions. Let the pedicurist know you have diabetes. Inform that too hot water isn’t advisable.

Your feet mirror your general health . . . cherish them!

 

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