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Effective Diabetic Foot Care – A 3 Phase Approach

This is the final article in the 3-part series in commemoration of World Diabetes Day 2017. The previous ones focused on: factors that increase the risk of developing foot problems, and symptoms;  when to seek medical care, and the diagnostics required. Today, self-care at home; medical treatments; and follow up actions are addressed.

Self-Care at Home

A person with diabetes should pay careful attention to/do the following:

  • Foot examinations:Make it a daily practice, and also after any trauma, no matter how minor. Report any abnormalities to your physician/ podiatrist. Use a moisturiser every day (but not between your toes), to prevent dry skin and cracking. Wear cotton or wool socks.
  • Toenail trimming: Always cut your nails with a safety clipper, never a scissors. Cut them straight across. If you have difficulty with your vision, or using your hands, let your podiatrist do it for you; or train a family member how to do it safely.
  • Footwear:Wear sturdy, comfortable shoes, whenever feasible, to protect your feet. To ensure your shoes fit properly, see a podiatrist for recommendations. If you have flat feet, bunions, or hammertoes, you may need prescription shoes or shoe inserts.
  • Exercise:Regular exercise will improve bone and joint health in your feet and legs; improve circulation to your legs; and help to stabilise your blood sugar Do consult your physician prior to beginning any exercise program.
  • Smoking:If you smoke any form of tobacco, quitting can be one of the best things, to prevent foot problems. Smoking accelerates damage to blood vessels, especially small blood vessels. It can lead to poor circulation, which is a major risk factor for foot infections, and ultimately amputations.
  • Diabetes control: Following a reasonable diet, taking your medications, checking your blood sugar regularly, exercising regularly, and maintaining good communication with your health care providers are essential factors for control of your Consistent long-term blood sugar control to near normal levels, can greatly lower the risk of damage to your nerves, kidneys, eyes, and blood vessels.

Medical Treatment

  • Antibiotics: If the doctor determines that a wound or ulcer on the patient’s feet or legs is infected, or if the wound has a high risk of becoming infected, antibiotics will be prescribed to treat the infection. It is very important that the entire course of antibiotics is taken as prescribed. Generally, some improvement in the wound should be seen in two to three days; sometimes from the first day. For limb or life-threatening infections, the patient will be admitted to hospital and IV antibiotics given. Less serious infections may be treated with pills, as an outpatient. The doctor may give a single dose of antibiotics, as a shot or IV dose, prior to starting pills, through a clinic or emergency department.
  • Referral to podiatrist or orthopaedic surgeon: If the patient has bone-related problems, toenail problems, , hammertoes, bunions, flat feet, heel spurs, arthritis, or have difficulty with finding shoes that fit, a physician may refer you to one of these specialists. They create shoe inserts, prescribe shoes, remove calluses and have expertise in surgical solutions for bone problems. These professionals can also be an excellent resource for how to care for patient’s feet routinely.
  • Home health aide:The patient’s doctor may prescribe a geriatric nurse or aide to help with: wound care and dressings; monitoring of blood sugar; taking antibiotics and other medications properly during the healing period.

Follow-up Actions

  • Read any instructions from the doctor/ podiatrist while still in their office. Ask questions about any instructions you don’t understand, and follow all of them. Let the health professional know if your condition is not improving, within a reasonable time.
  • Ensure the entire course of antibiotics if prescribed by the doctor is finished. Not completing the full course, can lead to bacteria becoming resistant to antibiotics.
  • Less pain, swelling, redness, warmth, or drainage are generally all signs of improvement in an infected wound. Shrinkage of the wound or ulcer; absence of fever, are also good signs. Usually, some improvement should occur within the first two to three days. Let a doctor/podiatrist know, if improvement is not as expected.
  • Be especially vigilant about diabetes care while there is healing of a foot or leg infection. Good glycaemic control is not only good for healing an existing ulcer, but also for preventing future ones. Check blood sugar regularly and let a doctor know the pattern of low and high levels.

Compliance is key to positive results, act accordingly… it’s in your best interest.

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

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