Losing a toe, foot, or leg due to complications of diabetes is the nightmare of many patients with this disease. Amputations in feet and legs are 10 times more frequent in patients with diabetes than in the rest of the population.
Living with diabetes puts you at risk for neuropathy. Peripheral neuropathy, reduced blood flow to the feet and infections of wounds not treated in time, put at risk your health and that of your legs and feet.
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Control your glucose levels, take your medications, follow a healthy diet, exercise daily and take good hygiene of your feet, keep your feet healthy. They charge you and follow your steps, they deserve good treatment.
Step 1. Control glucose, blood pressure and blood cholesterol
Controlling blood glucose will help you have healthy feet. In your health care routine, it includes a glycosylated hemoglobin (HbG) or AC1 test. This test shows the level of blood glucose between two or three months before you undergo the test, so you know if you are controlling your diabetes well.
Check your blood pressure frequently, it should be below 130/80. If it stays higher for an indefinite period, your doctor can prescribe medication to help regulate it.
Include a cholesterol test in your annual review. Your LDL ("bad" cholesterol) test levels must be less than 100.
In the HDL ("good" cholesterol) test, ideal values should be greater than 40 in men and over 50 in women.
Step 2. Check your feet daily
If you live with diabetes you can have serious problems in your feet without feeling any pain. Get in the habit of checking your feet every night. When inspections, look for wounds, sores, red spots, swelling or infection in the skin and nails.
When you do not control your diabetes, the nervous tissue in your body is damaged. When this happens, the nerves stop sending signals to the brain, send them very slowly, or send erroneous messages. Peripheral nerves, which range from the spinal cord to the extremities, are the most affected. This condition is called neuropathy.
That's why it's important that you check your glucose levels and check your feet every day. If it is difficult for you, ask someone to review them for you.
Step 3. Keep your feet clean, dry and soft
Wash your feet well every day. Use warm water, not hot. A temperature between 90 and 95 degrees F is safe. Dry your feet well, especially between your fingers. You can use talc or corn starch to keep the skin between your fingers dry.
With clean feet, trim the toenails with a nail clipper, in a straight line, without cutting the corners. Soften the corners with a nail file. If you do not see well, if the nails are thick or yellow, curved and grow on the skin, let your podiatrist take care.
If your doctor allows it, after showering, soften the calluses with a pumice stone. Lime in one direction to avoid breaking the skin. Do not cut calluses or use razors.
Apply a thin layer of skin lotion, moisturizer or Vaseline on the top and bottom of the feet. Do not apply between your fingers, it could cause infection.
Be very careful with spas or salons that offer manicure and pedicure, they could do more harm than good to your feet. If you do not have good sensitivity in your feet, the hot water in the spa tub or the paraffin or wax treatment to soften the feet, it could be very hot and burn your feet without you feeling it. Maybe they could push the cuticle very hard on the toes, or cut it off, and a wound around the toenails could get infected quickly. Only with the consent of your doctor can you visit a spa for a pedicure.
Step 4. Wear shoes and socks from the morning until going to bed
From the moment you jump out of bed until the moment you return at night to sleep, your feet have to be protected.
If you are barefoot, you may not feel the moment a scratch, blister, cut or even an insect bite occurs on your feet. Although it sounds exaggerated, these simple skin lacerations, if not treated at the time, can become infected and cause more damage.
Always use clean socks and no holes. When you wear shoes without socks they can create blisters on your feet. Before, it was thought that the cotton material was the best, but the cotton retains the sweat. Today experts recommend socks made for athletes with materials that are very absorbent (Coolmax® and Ultimax®) and keep your feet dry of sweat while you exercise.
During the summer or the hot months, or if you go to the pool, lake or beach, wear shoes that you can use in the water, never be barefoot.
Step 5. Protect your feet from extreme heat and cold
Watch your feet for extreme temperatures. In the summer apply sunscreen on the top of the feet to avoid burns. Never walk barefoot, much less on the beach or on the hot pavement.
In the winter, keep your feet away from radiators and chimneys. Do not put hot water bags or heating pads, use socks if your feet get cold. The lined boots are good in the winter to keep your feet warm. Check your feet frequently during the winter to avoid freezing.
Electric blankets are an option during winter, but you should be cautious when using them. Experts recommend that you warm the bed with the electric blanket before going to sleep. You should not sleep with the blanket, just use it to warm your bed. When the bed is warm, turn off the blanket and remove it from the bed.
Step 6. Exercise daily
Physical activity helps you control your diabetes. Consult your doctor or health educator about a daily activity program that resembles your needs.
Walking, dancing, swimming and cycling are forms of exercise that do not hurt your feet so much.
Avoid jumping or running. Begin your exercise routine with a short warm-up and cool down period at the end of it. Remember to wear athletic shoes that fit you well and give you support.
Step 7. Foot sensitivity test
In the consultation with your doctor clarify all your doubts about the care of the feet. Ask him about the best way to take care of your feet, tell him if you have had serious problems in your feet during the last year and if there is some kind of footwear that can help you keep your feet healthy.
Ask your doctor to examine the sense of touch and the pulsations in your feet. This test is done every year, but you do not have to wait a year to be tested for sensitivity in the feet, the earlier you detect if there is a lack of sensitivity in your feet, the better.
The sensitivity test on the feet you can do at home with the help of a flexible filament of nylon similar to the filaments of the brushes to brush the teeth or hair, applying light pressure on different points under the feet.