Diabetic foot problems are a major concern in medical care and a common cause of hospitalization.
Most of the foot problems faced by people with diabetes arise from two serious complications of the disease: nerve damage and poor circulation. The lack of sensitivity and the reduced blood flow allow a small blister to progress to become a serious infection in a matter of days. Chronic nerve damage (neuropathy) can cause dry and cracked skin, which gives an opportunity for bacteria to enter and cause infection.
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The consequences can range from hospitalization to administer antibiotics to amputation of a toe or full foot. For people with diabetes, daily and careful inspection of the foot is essential for general health and prevention of problems that damage the foot.
Diabetic foot (Charcot) (Diabetic Charcot Foot)
Staying Healthy
Smoking and musculoskeletal health (Smoking and Musculoskeletal Health)
General care of the diabetic foot
- Never walk barefoot. The damage of the nerves diminishes the sensation, thus it can happen that you do not feel pebbles or small objects trapped in your foot. This can lead to a massive infection. Always wearing shoes or slippers reduces this risk.
- Wash your feet every day with a mild soap and warm water. First test the water temperature with your hand. Do not soak your feet. When you dry them, gently pat each foot with a towel instead of vigorously rubbing them. Be careful with drying between your toes.
- Use lotion to keep the skin of your feet soft and moist. This prevents cracks that are made by dry skin and reduces the risk of infection. Do not put lotion between your fingers.
- Cut the toenails without giving them a curved shape. Avoid cutting the corners. Use a file or emery board for nails. If you detect an ingrown toenail, see your doctor. Good medical care is important in the prevention of infections.
- Do not use antiseptic solutions, over-the-counter medications, heat pads, or sharp instruments on your feet. Do not put your feet on the radiators or in front of the stove.
- Do not let your feet get cold. Wear loose socks on the bed. Do not get your feet wet in the snow or in the rain. Wear warm socks and shoes in winter.
- Do not smoke. Smoking damages blood vessels and reduces the body's ability to transport oxygen. In combination with diabetes, this significantly increases your risk of amputation (not only of the feet, but may also include the hands).
Inspection
- Inspect your feet every day.
- Look for stings or punctures, bruises, pressure points, redness, heat areas, blisters, ulcers, scratches, cuts and nail problems.
- Ask someone to help you or use a mirror if you can not do it alone. Maybe you do not have the feeling that the skin was damaged. Inspecting the skin to detect wounds is essential.
- Observe and feel each foot to see if there is inflammation. The inflammation in one of the feet and not in the other is an early sign of possible Charcot's disease in the initial stage. This is a unique problem that can occur in people with nerve damage. It can destroy bones and joints.
- - The tip of the big toe
- --The base of the small fingers
- --The base of the middle fingers
- --Heel
- --The outer edge of the foot
- - The forefoot transversely (the most bulky support area of the sole of the foot, which joins the base of the fingers)
Footwear
Choose and wear your shoes carefully. A shoe that fits badly can cause an ulcer and lead to an infection.
- Buy new shoes at an hour late in the day when your feet are longer. Buy shoes that are comfortable without needing a "soft" period.
- Check the fit of your shoe in the width, length, back, base of the heel and sole of the foot. Have your feet measured every time you buy new shoes. The shape of your foot will change over the years and your shoe size may not be the same as 5 years ago.
- Avoid shoe styles with pointed toes and high heels. Try to get shoes with leather tops and deep toes for your fingers.
- Wear new shoes only for 2 hours or less each time. Do not wear the same pair of shoes every day.
- Inspect the inside of each shoe before putting it on. Do not tie your shoes too tight or too loose.
- Avoid long walks without a break, organize to take off your shoes and socks and check for signs of pressure (redness) or ulcers.
Orthopedics
Insurance companies often cover the cost of orthopedic items for people with diabetes. They understand the importance of minimizing the risk of a pressure sore in these patients. Discuss this with your primary care doctor or orthopedic surgeon.
It is common to prescribe a flexible template made with a soft material called "plastizote". The orthopedic elements should not be hard, because this will increase the risk of ulcer by pressure. The template can be transferred from shoe to shoe, and should be worn at all times when the person is standing or walking.