As a result of poor control of diabetes, there is a decrease in the blood supply of the legs (vasculopathy) and an involvement of the nerves of the legs and feet (neuropathy), this is what we call diabetic foot.
When we are facing a decompensated diabetes with long evolution, the chances of lesions on the feet increase.
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Neuropathy can manifest as a hypersensitivity in the form of cramps, throbbing or burning pain. It worsens with night rest and improves when you put your feet on the floor.
The most common is that there is a decrease in sensitivity, noticing the feet asleep from the tips of the fingers upwards (in a sock), with a sensation of concussion reaching, even, not to notice the pain.
In this way, any small scratch, wound or crack can go unnoticed and serve as a gateway to a possible infection.
It is for all this that the person with diabetes must watch and take care of the hygiene of their feet.
Norms for the care of the feet
- The feet should be observed daily, looking for any small scratches, wounds or redness. Six places on the sole of the foot should be controlled: the tip of the big toe, the base of the small fingers, the base of the middle fingers, also the heel and the outside of the foot and the sole.
- Do not smoke. The tobacco narrows the arteries and does not favor an adequate supply of oxygen to your feet. Go periodically to your doctor to ensure good control of your diabetes and other cardiovascular risk factors (hypertension, dyslipidemia, etc.). It is advisable to exercise daily in the form of walks on flat terrain and at a good pace for at least one hour.
- Keep your feet clean, washing them daily with warm water (remember that the nerves that conduct thermal sensitivity may be damaged and not notice that the water is hot enough to produce a burn) and soap. The drying must be thorough, striving to eliminate moisture from the interdigital area. It is about keeping them hydrated, without moisture or calluses. In the event that you have excessive sweating, it is recommended to apply talcum powder after daily washing.
- For the care of the nails, you should use blunt scissors and cardboard file. All this, with good light and using the help of a magnifying glass and mirror, if necessary. Never use sharp pointed scissors, nail clippers or other sharp objects. Nor metal files, callicides or pumice stone. The nails should be cut straight away avoiding cutting the sides. In any case, whenever you can not perform these care with the precision they require, you should go to the podiatrist.
- Regarding the dress of the feet, never use synthetic socks and thick seams, or garters or belts that compress and compromise circulation. It is best to use socks made of natural fibers (cotton, yarn or wool) and light colors for the early detection of wounds. To warm your feet, do not use electric blankets or hot water bags. It is also not advisable to sit near stoves or braziers because of the risk of burns if the thermal sensitivity is altered.
- Regarding footwear, it is necessary to use leather shoes, comfortable and wide, where each finger has space with slack. It is also advisable that the foot is well secured, with footwear that is tied with laces or velcro. Check the inside of the shoe every day with your hand in search of anything that, however small (pebble, ...), passes unnoticed and can cause an injury or chafing.
- When we release shoes, it is advisable to make a slow adaptation by using them no more than one hour in a row during the first days. Choose as the shoe purchase time the last hour of the afternoon, since it is when the foot is more dilated. Never walk barefoot, not even on the beach. At home, use comfortable shoes.
- Regarding wounds and cures, it is necessary that they be evaluated by the doctor, who will indicate the type of care that must be performed on it. All this can be summarized in observing, protecting and caring, which, in short, is aimed at preventing the appearance on the feet of injuries, whose consequences can be fatal.