Diabetic people are more likely to have problems in their feet than the rest, so it is essential to take good care of the feet.
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The circulation of blood in the lower extremities decreases with age, further reduced by the effect of diabetes. Since sensitivity is also lost (due to diabetic neuropathy), there is a greater propensity to infections in the feet of people with diabetes.
A good care of Diabetes should be completed every day with a few minutes dedicated to the care of the feet, which will be of great value to avoid complications. It would be, fundamentally to have the feet always in good condition, clean, take care not to get hurt, chafing or irritation, that the feet are not too dry and prevent deformations, all aimed at preventing infections.
Improve the circulation of blood in the legs and the lack of sensibility of the nerves in the feet. For example, tobacco, excessive heat and cold, alcohol and other drugs can harm them.
Why is foot care important in the diabetic patient?
In the evolution of Diabetes, the most frequent complications are the involvement of nerves and arteries. Vascular alterations alter the blood circulation and facilitate the appearance of edema and poorly vascularized areas, which hinder the healing of injuries and wounds. Diabetic neuropathy causes loss of sensation, muscle atrophy and pain.
Both alterations have special repercussions on the feet, often increasing erosions, punctures, cuts, burns ... which, if not taken care of, turn into ulcers, facilitate infection and can lead to gangrene and the need for amputations.
How should the feet be taken care of in the diabetic patient?
To avoid the appearance of ulcers, lesions, infections and necrosis in the feet, it is very important that the diabetic patient maintains a good control of the glycaemia and avoids the factors that can increase the risk of vascular and nervous lesions by:
- Control of blood glucose, maintaining correctly the treatment with insulin and / or oral hypoglycemic agents.
- Dietary diet that facilitates the stability of blood glucose levels, prevents obesity and ensures adequate supply of proteins, vitamins and minerals to the body.
- Physical exercise that facilitates the maintenance of adequate weight, glucose metabolism and correct blood circulation in the feet.
- Keep good control of blood pressure and blood lipid levels.
- Do not smoke or consume alcohol or other drugs.
- It is also essential to take care of the feet daily, checking them to see if wounds, chafing, blisters or cracks appear. For the daily review, good natural lighting is recommended and well inspected all the areas of the floor and the interdigital spaces with the help of a mirror. The doctor should be consulted in case of lesions, change of color, pain or swelling of the feet.
- The correct hygiene of the feet and the right choice of footwear is the basic strategy to avoid the appearance of chafing, wounds, burns and injuries:
- Wash your feet daily with warm water (not too hot-not exceeding 37 degrees or too cold) and neutral soap without forgetting the areas between your fingers. It is recommended not to soak them for more than 5 minutes. It is also advisable to check the temperature of the water with a bath thermometer or with the elbow, since it is common for the feet to lose sensitivity and not to perceive the actual water temperature.
- Dry the feet well with a soft towel and without rubbing, with special care in the interdigital spaces. If the skin is very dry, you can apply a moisturizer but with the precaution of not applying it in the interdigital spaces.
- Keep your feet dry by using non-medicinal talcum powder before putting on shoes in the morning and every time you change socks or footwear.
- The toenails should be cut with blunt-tipped scissors, and in a straight line to avoid incarnation, without rushing the cut or eroding the fingers. It is advisable to use a file to maintain the length of the nails and polish the edges.
- The hardness and calluses of the fingers should not be cut or removed, nor should callicides be used. If necessary, the Podiatrist should be consulted.
- Ointments, alcohol or disinfectants should not be used for foot wounds, as they can irritate the skin or change the color of the skin and wound, making it difficult for medical follow-up. Consult your nurse who will guide you in how to treat them.
- The feet should not be placed near the fire, stoves or sources of heat.
- The use of rubber bands, rubber bands or socks with elastic on the edge should be avoided as they hinder blood circulation.
- Avoid walking barefoot.
- Use sunscreen also on your feet if you are exposed to the sun.
Recommendations regarding footwear
The tips regarding footwear are the following:
- Daily change of socks or stockings that must be made of natural fabrics (cotton, wool, linen, yarn) and without seams. No synthetic stockings or socks should be worn, with elastics or rubber bands. They should not be tight or loose in the leg and foot. If the feet sweat a lot or have done a lot of exercise they should be changed more than once a day. If you have cold feet, use cotton or wool socks.
- Do not wear sandals, flip flops or shoes that leave your feet uncovered.
- Always wear shoes with socks. The inside of the shoe should be checked before putting it on, to avoid any element (stone, gravel, any part of the shoe ..) that could injure the foot.
- It is recommended that the new shoes be of leather, comfortable and without stitching on the inside, that fit well without causing injuries or razures on the feet, leaving room for the fingers, avoiding the narrow toes, and holding the heel area properly (neither too soft nor too rigid). That they be flexible, comfortable, light, breathable, and with the floor that does not slip. If the feet are very deformed, use special footwear.
- Do not wear a high or flat heel (2 to 5 cm).
- It is recommended to buy the shoes at the end of the day, when the feet are more swollen, so the shoe that at that time is comfortable, it is guaranteed that it will be throughout the day. I should not notice friction or pressure when trying it.
- It is important that during the first days of use, take them a short time (from half an hour to an hour). Later, alternate the use of new shoes with the most used. When the shoes are deformed by use, replace them with new ones.
- The purchase of orthopedic shoes must be made under criteria and medical prescription.
- It is advisable to have more than one pair of shoes to change them every day and to alternate them, thus ensuring a good ventilation of the shoes and avoiding the pressure always in the same area.
conclusion
It is fundamental that the diabetic patient is going to check the feet by the sanitary equipment periodically, fulfilling his indications and watching the wounds and injuries of the feet.
Unlike other complications of Diabetes, a significant proportion of this pathology is susceptible to prevention through a protocolized examination of the feet of diabetic patients (inspection of the foot, MF 5.07 sensitivity scan and peripheral pulses) and adequate health education of the patient.
A good protocolization of diabetic care, together with a correct education of the patient in self-care can reduce amputations by up to 50%.