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How to care for and prevent diabetic foot

What care does the diabetic foot require?

People with diabetes have a much higher risk of foot ulcers that can become complicated and even result in amputation. Something that can be avoided by controlling the disease and giving special care to the feet.



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Not paying attention to our feet can lead to health problems, but in the case of a diabetic person this can lead to something much more serious.

According to data from the Official College of Podiatrists of the Community of Madrid (COPOMA) up to 34% of people with diabetes can develop foot ulcers.

But not only that: the rate of amputation per diabetic foot is 52 per 100,000 inhabitants, well above countries such as France, Italy or the United Kingdom. Something that, according to Dr. Pedro Villalta, president of the Official College of Podiatry of the Community of Madrid (COPOMA), could be avoided in most cases with the intervention of a podiatrist on time.

What is the diabetic foot

This disorder is a consequence of diabetes when it is not well controlled , and even if it is well controlled there may be some degree of incidence. And is that high blood glucose levels cause:

•     An involvement of the nerves of the legs and feet (neuropathy), so that the person loses sensitivity in this area.
•     A decrease in the blood supply to the legs and feet (vasculopathy).
•     People with diabetes should take special care of their feet

Both situations ( lack of sensitivity and poor circulation ) can cause what starts with a simple wound in the foot to end up turning into an ulcer with dire consequences.

This happens because, as Dr. Villalta assures, the patient "usually overlooks that little foot wound because he does not notice any pain nor does he have a habit of checking his feet. Small wound in a patient with diabetes is much more serious than in a healthy person because, by failing the circulation, it heals much worse, which increases the risk of infection and have to amputate the finger.

How to take care of diabetic foot

Dr. Villalta assures that the consequences of diabetic foot could be avoided . First of all having the disease under control with the proper medication, as well as diet and exercise. And on the other hand it is very important to be very careful with your feet. Therefore, if you have diabetes:

•      Check your feet every day and look for any signs of a small scratch, wound, redness, changing the color of the nails ... Look closely between the toes, the nails, the heel ... To observe the sole of the feet Help yourself with a mirror. At the slightest sign of injury, go to the podiatrist to make the appropriate cure.
•     Wash them daily with warm water. Whether it is very cold or very hot, it attacks the lipid barrier of the skin. Do not have your feet more than 5 minutes soak and avoid using gloves of horsehair or pumice. And it dries the feet very well, especially between the fingers, so that there are no wet areas.

    The diabetic person has to check their feet daily

•     Hydrate the feet two or three times a day with a specific cream. Do not leave any corner without hydrating: the plant, between the fingers ... If the skin is dry it has a greater tendency to suffer cracks that are a gateway to germs and, consequently, infections.
•     Use socks from natural fabrics without seams and change them daily. Unsuitable socks can also cause minor injuries or hinder circulation, especially if they squeeze the ankles.
•      The shoes must be of good quality: leather, without internal seams, lightweight and breathable. It is very important that it adapts very well to the foot and that it does not tighten. One tip is to buy it at the end of the day as the foot is more swollen, so you will not find surprises.
•     Avoid sandals, high heels or narrow tips as they can cause chafing. The choice of footwear is essential because it is one of the factors that most influences the appearance of possible injuries.

    At the smallest foot injury you should go to the podiatrist

•     Check the inside of the shoes daily with your hand. There may be some pebbles or anything else that, having little sensation in the foot, may go unnoticed and cause an injury.
•     Cut the toenails straight to avoid nailing the sides.
•     Avoid walking barefoot, both at home and on the beach. The diabetic person must especially protect their feet since they have very little sensitivity in them.

And remember, even if you do not have any injuries and control the disease, you should go every 6 months to the podiatrist for an in-depth review.

With proper care the diabetic foot does not have to give problems, but without them the risks are very high. In fact, Dr. Villalta says that podiatry should be included in Social Security as part of the treatment needed by the diabetic patient in Primary Care. This is a demand from COPOMA and many other schools of podiatrists.

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Do you have diabetes? 8 tips for the care of your feet

The biggest fear of people with diabetes is that they can lose a toe, or even the entire foot. Although this complication of diabetes is a real risk ... calm down! It does not have to happen to you if you know how to take care of your feet.



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Why are your feet at risk when you are diabetic? The lack of control of blood sugar for several years and specifically the high levels of sugar in your blood can damage the nerves ( diabetic neuropathy ) of your feet causing you to lose sensitivity, and can also affect your blood vessels causing poor circulation.

Therefore, if one day you hit or you get a wound or you get an ulcer on one foot, it is very likely that you do not feel it and do not realize it, and also that the wound can not be easily cured by poor circulation of the blood. And when you can not heal a wound quickly, it can become seriously infected and can even cause gangrene. In the long term, you may end up losing a finger, your foot or an entire leg.

Do you see why it is so important to take care of your feet? In Life and Health we give you these tips:

1. Never walk barefoot!

Even if you are at home and they tell you that the floor is impeccable, always protect your feet with socks (socks) and shoes. Not even when you are on the beach or in the sea, where you do not know what you could step on. Better put on sneakers.

2. Check them daily

To prevent any injury, blow, scrape or blister that you have not noticed, you get infected. And do not leave the floor of the foot careless, use a mirror if you can not see it easily.

3. Keep them clean and dry

Wash your feet daily in warm water and mild soap. Dry them gently, without rubbing the skin tightly. Make sure especially that the part between the fingers is very dry.

4. Use a moisturizing cream on the rough parts

In extremely dry parts such as heels, put on a moisturizer to soften the skin . But it prevents cream from falling between the fingers.

5. Beware of nails

Cut your nails after showering (to bathe), when they are soft. Cut them with the shape of the finger and be careful not to cut your skin or hurt yourself with the nail clipper. And never cut corns alone, ask for help from a specialist, your doctor or a podiatrist.

6. Be careful with shoes

As much as you like those new shoes, do not wear them if they cut or scrape you. Even the smallest blisters can become infected and complicated. That's why you should also be careful with shoes that expose your fingers and your heels, with high heels with closed ends, or even with any shoe that has internal seams that could hurt your feet.

7. Do not forget the socks (stockings)

Try not to be tight and not have uncomfortable seams. And of course, change them daily.

8. Visit your doctor

Do it frequently and always ask him to check your feet. And if you find a wound, do not wait! Call him immediately to help you control any infection and heal it quickly. Any wait can be dangerous.

As soon as these cares are part of your daily routine, then you will not notice the time you spend them. Your feet will thank you.

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Diabetes and foot problems

Foot problems are common in people with diabetes. Maybe you're afraid of losing a toe, a foot or a leg, or maybe you know someone who has been through that. However, you can reduce the likelihood of having problems with your feet with good daily foot care. Controlling blood glucose levels (blood sugar) can also help keep your feet healthy.



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How can diabetes affect the feet?

Over time, diabetes can cause nerve damage, which is also known as diabetic neuropathy , which can cause pain and a tingling sensation, and can make you lose sensation in your feet. When you lose feeling in your feet, you may not feel a pebble in your sock or a blister on your foot, which can cause cuts and sores. Cuts and sores can become infected.

Diabetes can also decrease the amount of blood flow in the feet. If you do not have enough blood flow in your legs or feet, it is harder for a sore or infection to heal. Sometimes, a severe infection of the nerves is never cured. The infection can cause gangrene.

If gangrene and foot ulcers do not improve with treatment, you can amputate the toe, foot, or part of the leg. A surgeon can do an amputation to prevent a serious infection from passing to the rest of the body, which could save your life. Good foot care is very important to prevent serious infections and gangrene.

Although it does not happen often, nerve damage from diabetes can cause deformation of the feet, such as Charcot's foot. Charcot foot can start with redness, warmth and swelling. Then, the bones and toes begin to move or break, which causes the foot to take on a strange shape, like the "clubfoot".
Illustration of the foot of Charcot that presents a widening of the sole in a rounded shape. Charcot's foot can make the foot take a strange shape, like the "clubfoot".

What can I do to keep my feet healthy?

Work with your health care team to create a personal diabetes care plan, which consists of an action plan on how to manage diabetes. The plan must include foot care. A podiatrist (foot specialist) and other specialists can be part of your health care team.

Include these steps in your foot care plan:
Suggestions for foot care

•     Check your feet every day.
•     Wash your feet every day.
•     Gently rinse calluses and calluses.
•     Cut your toenails in a straight line.
•     Always wear shoes and socks.
•     Protect your feet from heat and cold.
•     Help maintain blood flow in the feet.
•     Ask to have your feet checked at each medical visit.

Check your feet every day

Maybe you have foot problems and do not feel pain. Checking your feet every day will help you find problems at an early stage before the problems get worse. A good way to remember it is by checking your feet every night when you take off your shoes. Also check the area between the toes. If you find it difficult to bend to see your feet, try using a mirror or ask someone to check them.

Watch for problems such as:

•     cuts, sores or red spots
•     swelling or blisters with fluid
•     Ingrown nails, when the edges of the nails grow buried in the skin
•     corns and calluses, which are circular lesions of hardened skin caused by too much friction or pressure in the same place
•     plantar warts, which are flesh-colored growths on the soles of the feet
•     athlete's foot
•     hot areas on the feet

A person is examined the sole of the foot.

If you have certain foot problems that increase your chance of developing sores on your feet, your doctor may recommend that you take skin temperature on different parts of your feet. A "hot area" may be the first sign that a blister or ulcer is beginning to develop.

Cover blisters, cuts or sores with a bandage. Limit calluses and calluses as explained below.
Wash your feet every day

Wash your feet with warm water (not hot) and soap. Feel the temperature of the water to make sure it is not too hot. You can use the elbow or a thermometer (between 90 ° and 95 ° F or between 32 ° and 35 ° C is a safe temperature) to feel the temperature of the water. Do not soak your feet because your skin will dry out.

The foot and hands of a person who examines the toes.

After washing and drying your feet, put talc or corn starch between your toes. The skin between the toes tends to retain moisture. The powder will keep the skin dry, which will help prevent an infection.

Gently rinse corns and calluses

Thick layers of skin known as calluses or calluses may appear on the feet. If you have them, talk with your podiatrist about the best way to take care of these foot problems. If you have nerve damage, these layers can become ulcers.

A woman smoothes the sole of her foot with a pumice stone.

If the doctor tells you to, use a pumice stone to file calluses and calluses after a bath or shower. Pumice is a type of rock that is used to file the skin. Rub it gently, in one direction, to avoid breaking the skin.

It is important that NO:

•     cut corns and calluses
•     use patches for corns, which are medicated pads
•     use liquid callus remover

Products without a prescription or to cut or eliminate calluses can damage the skin and cause infections.

To keep the skin soft, apply a thin layer of lotion, cream or Vaseline on the top and bottom of the feet. Do not apply lotion or cream between your toes because moisture could cause an infection.

Cut your toenails in a straight line

Cut your toenails, when necessary, after washing and drying your feet. Cut your toenails in a straight line with a nail clipper. Do not cut the corners of the toenails. Gently wipe each nail with a cardboard file or a nail file that is not too sharp. Cutting the nails in this way helps prevent cuts on the skin and ingrown toenails.
A person cuts his toenails.

Ask the podiatrist to cut your toenails if:

•     you can not see, feel or reach your feet
•     Has thick or yellowish toenails
•     has curved nails or is incarnated

If you want to get a pedicure in a salon, you must bring your own nail utensils to avoid getting an infection. You can ask your health care team about other steps you can take in the room to prevent an infection.

Always wear shoes and socks

Always wear shoes and socks. Do not walk barefoot or in socks only, even in closed spaces. He could step on something and hurt his feet. Maybe he does not feel pain and does not realize that he got hurt.

Before putting on shoes, check inside to make sure that the lining is smooth and free of pebbles and other objects.

A man touches the inside of the shoe.

Be sure to wear socks, socks or nylon socks with your shoes so you do not get blisters or sores. Wear clean, lightly padded socks that fit well. Seamless socks are the best option.

Wear shoes that fit well and protect your feet. Here are some suggestions to find the right footwear:

•     Walking or sports shoes are a good option for everyday use. They offer good support for the feet and allow them to "breathe".
•     Do not wear vinyl or plastic shoes, because they do not stretch or allow your feet to "breathe".
•     When buying shoes, make sure you are comfortable with your shoes on and that they have enough space for your toes. Buy the shoes at the end of the day, when the feet are more swollen, so you can find the one that suits you best.
•     If you have bunions, or hammertoes, that cause your toes to bend under your feet, you may need wider or deeper shoes. 1 Do not wear shoes with sharp or narrow toe or high heels, because these put a lot of pressure on the toes.
•     If you have foot deformities, such as Charcot's foot, you may need special shoes or insoles, which is known as orthopedics. You may also need templates if you have bunions, hammertoes or other foot problems.

To soften or mold new shoes, wear them only for a few hours at first, and then check your feet to see if there are areas of pain.

Medicare Part B insurance and other health insurance programs can help you pay for these shoes or special templates. Ask your insurance plan if it covers shoes or special templates.
Protect your feet from heat and cold

If you have nerve damage from diabetes, you could burn your feet without knowing it. Take the following steps to protect your feet from heat:

•     Wear shoes on the beach or hot pavement.
•     Use sunscreen on the top of your feet to avoid sunburn.
•     Keep feet away from heaters and fires.
•     Do not put hot water bottles or heating pads on your feet.

A person with sports shoes walks in the sand.

• Wear socks to sleep if your feet get cold. In the winter, wear waterproof boots with lining on the inside to keep the feet warm and dry.
• Help maintain blood flow in the feet

Follow the following suggestions to improve blood flow in the feet:

•     Put your feet up when you are sitting.
•     Move the toes for a few minutes during the day. Move the heels: lift them, lower them, bend them towards you and move them to help the blood flow in the feet and legs.
•     Do not wear tight socks or elastic stockings. Do not try to hold loose socks with elastic bands.
•     Get more physical activity Choose activities that do not put much effort on your feet, such as walking, dancing, yoga or stretching, swimming or riding a bicycle.
•     Stop smoking.

A seated man reads a book and rests his feet on a small chair for the feet.

Smoking can reduce the amount of blood flow in the feet. If you smoke, seek help to stop smoking. You can get help by calling the national quitline at 1-855-335-3569 or 1-855-DEJELO-YA. For suggestions on how to quit smoking, visit Spanish smokefree .
Ask to have your feet checked at each medical visit

Ask your health care team to have your feet checked at each visit. Take off your shoes and socks when you are in the exam room so they remember to check your feet. At least once a year, have a complete foot exam, including checking the sensitivity and pulse of the feet.
A doctor examines a person's feet.

Ask to have your feet examined at each doctor's visit if:

•     see changes in the shape of the foot
•     have loss of sensation in the feet
•     have peripheral arterial disease
•     has had ulcers on the foot or some amputation in the past 1

Ask your health care team to show you how to take care of your feet.

When should I see the doctor about foot problems?

Call your doctor immediately if you have:

•     a cut, blister or bruise on the foot that does not start to heal after a few days
•     redness, sensation of heat or pain in the skin of the feet, signs of a possible infection
•     a callus with dried blood inside, which can often be the first sign of an injury under the callus
•     an infection of the foot that turns black and smells bad, signs that you might have gangrene

Ask your doctor to refer you to a podiatrist or podiatrist, if necessary.

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Foot care in diabetics

ULCERAS APPEAR IN 15% OF DIABETICS !!

Ulceras.net encourages you that if you are diabetic, you go regularly to your Nurse in the health center or to your Family Doctor, Endocrine or Podiatrist so that at least once a year they check your feet to detect any problem in a way preventive before it's too late.



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Here we recommend a series of simple measures in relation to foot care:

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.


HYGIENE AND CARE OF THE FEET IN THE DIABETIC PATIENT

The care of the feet is very important and more so in the diabetic patient, because due to the decrease in sensitivity, with or without the coexistence of blood flow deficit, injury or ulceration can occur.

The prevention of ulcers or infections in the foot of the diabetic will depend on the degree of knowledge that the patient has in terms of hygiene, hydration or footwear.

Do not forget, it's up to you.

Follow the following instructions:

"You should observe your feet every day, 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 plant ".

HYGIENE

It is necessary to wash the foot daily with mitten, soft sponge or hand and warm water (less than 37º). Do not prolong the bath beyond 5 minutes so as not to cause the skin to macerate. Use neutral soap adding paraffin oil to the water to make it more emollient.


DRYING

To dry the feet it is better to do it by contact, avoiding friction as much as possible and paying special attention to the interdigital areas. If the foot does not dry well, the growth of pathogenic microorganisms is usually favored.

Hydration of diabetic feet

HYDRATION

After daily hygiene apply moisturizer on the heel plant and back of both feet to prevent dryness. For this use 15% urea creams. Hydrating the interdigital spaces or doing massages with alcohol or cologne is counterproductive.

THE ONES

The nails have a protective function, therefore, they should protrude 1 or 2 mm in front of the finger and in this sense, the nail cut should be straight and not curved like in the hands, the nails should be cut with round tip scissors or file with a cardboard file never metallic.

CALLICIDES

Do not use callicides or pumice stones, or manipulate calluses or other lesions on your feet, if you detect any abnormality, consult with your healthcare team.

FOOTWEAR

Knowing how to choose footwear is very important.

How to make shoes for diabetics

Shoe characteristics

•     Leather and non-slip sole
•     With laces or velcro
•     Wide heel and not too high (2-3 cm in men and 5 cm in women)
•     Seamless inside
•     Adjustable thermos
•     Lycra shovel (in case of alteration in the fingers)
•     Soles and heels must not be worn
•     They should not squeeze or be too baggy because they produce chafing
•     When buying new shoes it is convenient to go to the last hour of the day because it is when the foot is more bloated
•     Do not always wear the same footwear
•     The adaptation to new shoes must be progressive.

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.

PROTECTION

Avoid walking barefoot on any surface or floor. The foot should always be (at home, on the beach, in the pool etc.) well protected, to prevent unnecessary injuries.

Regarding the dress of the feet, never use synthetic socks and thick seams, or garters or belts that compress and compromise the circulation is most appropriate to use socks made of natural fibers (cotton, yarn or wool) and light tones for detection precocious wound

Do not use electric pads, hot water bottles or any other source of heat to warm your feet. You may burn without realizing it due to altered sensitivity.

TOBACCO

tobacco diabetic foot ulcers

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.

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How to take care of my feet if I have diabetes?

One of the most frequent complications of those who have this disease is diabetic foot. From Sanatorio Allende we tell you what are the cares to take into account to achieve a better approach to the problem and avoid injuries.



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The increase in blood sugar, added to other factors that occur in those with diabetes, influences our blood vessels and the peripheral and autonomic nervous system, that is, those neurons and nerves that are located or extend outside the system nervous central towards the limbs and organs. This nerve involvement is called Diabetic Neuropathy and can have different manifestations depending on the type of nerve fiber involved. Diabetic neuropathy is the most frequent chronic complication of diabetes and it is more prevalent in people with type 2 diabetes, that is, in those who have insufficient insulin production together with an inadequate use of it.

Generally, the presence and severity of neuropathies are related to the duration of diabetes and the degree of hyperglycemia of the patient.

This complication affects approximately 50% of patients with more than 25 years of evolution of the disease, and may be asymptomatic in up to half of the cases. The presence of symptoms will depend on the damaged nerve fibers and their manifestations can be numbness, pain, cramps or altered perception of pain, for example.

The loss of sensitivity produced by diabetic neuropathies favors, along with other predisposing factors (such as peripheral vascular disease or orthopedic disorders) the appearance of lesions that, if not treated properly, may require hospitalization to amputation. Lesions in patients with neuropathy develop more frequently in areas of pressure or friction, such as in the plantar region of the forefoot, pulp and lateral aspect of the first finger, back and fingertips. Also, in those who predominate the vascular component over the neuropathic, the most common location is the heel, the lateral edges of the feet and the bony prominences.

The foot of the person with diabetes should be considered a foot at risk, since it presents more susceptibility and likelihood of suffering injuries such as ulceration, infection and / or gangrene.

Las personas que padecen de diabetes deben prestar atención a la aparición de ciertos signos en el pie. (Sanatorio Allende)
People with diabetes should pay attention to the appearance of certain signs in the foot. (Sanatorium Allende)

Those who have diabetes should pay attention to the appearance of certain signs, such as dryness, cracks or changes in skin color and temperature; pain when walking; fatigue in the legs; and presence of cuts, blisters, ingrown toenails or calluses.

The possibility that a high percentage of patients is asymptomatic makes it necessary for both those who know their neuropathy and those who are apparently healthy to take preventive measures into account in order to avoid injuries to the foot.
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• Cuidados generales del pie. (Sanatorio Allende)
• General care of the foot. (Sanatorium Allende)

To take into account ...
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Socks:

•     Use seamless linen, cotton or wool socks as they absorb more moisture.
•     They should not fit or be too loose, and it is recommended to change them twice a day.

Shoes

•     Never walk barefoot, as it is possible to hurt yourself and not notice it.
•     Use soft and comfortable shoes, leather, closed, with laces or velcro. Do not wear tight shoes.
•     Check the inside of them before using them: check that there is no roughness and that the template is smooth.
•     When buying footwear it is suggested that it be in the afternoon, since it is the time of the day when the feet are more swollen. The new footwear should begin to be used gradually to prevent the formation of blisters.
•     Avoid high heels, as they can cause the appearance of pressure points. Women up to 5 cm and men no more than 2.5 cm tall.
• Hay que prestar atención especial cuidado e higiene de los pies. (Sanatorio Allende)
• Special care and hygiene of the feet must be paid. (Sanatorium Allende)

Hygiene and foot care:

•     Touch the water with your elbow to make sure it is not too hot.
•     Wash your feet with warm water and mild soap every day. The washing should not last more than 5 minutes.
•     Dry well between the fingers and the whole of the foot by contact and not rubbing.
•     Moisten the feet with creams at night, not between the fingers. Do not use powders, powders, alcohol or lotions.
•     Cut the nails straight and not too short after the bath, as they will be softer.

Inspection and search for injuries

•     Observe the feet carefully when removing the shoes.
•     Use a mirror to observe the sole of the foot.
•     In case of having spots, bruises, blisters or wounds, in spite of not being painful, consult the doctor.

Currently, new therapeutic resources are available that improve the chances of patient recovery. However, foot ulcers are usually difficult to cure, requiring in a high percentage of cases the combination of different treatments and several months for their total closure. The skin of the area affected by the ulcer, when healing with a tissue different from the normal one, may be more predisposed to re-injuring itself, especially if the factors that favored its development are not corrected.

To reduce the pressure in healthy hyperapodia areas or after the healing of an ulcer, it is necessary to use discharge templates made specifically for each person. They must be changed with a certain frequency depending on the material with which they are made.

Although, fortunately, not all patients with diabetes have neuropathy, educating the patient is a constitutive part of the treatment of this disease.

The incorporation of daily care habits, patient monitoring and glucose control are the basis for avoiding injuries and preventing possible complications linked to diabetic foot.

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The care of the skin and feet is essential in diabetics

Healthy feet and skin to fight diabetes

Diabetes brings with it a set of complications. Among them are the damages to important organs like the kidneys and the heart. But it also causes problems in the skin and feet.



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In these parts of the body the consequences of diabetes can be delayed. It is even possible to prevent them. For this it is important to keep a strict control of blood sugar levels. Performing exercises and maintaining a healthy diet is also recommended.

Although some obligatory precautions should never be ignored.

In the feet, the consequences of diabetes can be delayed.
Diabetes and skin

There are two ways diabetes can affect the skin.

•     Because of the loss of fluids caused by blood sugar. If the body has less fluid than it needs, the skin may dry out. That will cause it to be damaged and appear cracked, allowing the entry of microbes.
•     Due to the deterioration in the nerves of the organism. This type of process reduces the amount of sweat, which dries the skin.

How to care for the skin?

• - Take plenty of water. Liquids in general counteract the effects of blood glucose.
• - Use non-irritating soap. Then dry well, especially where water can hide.
• - After the bath, apply moisturizing cream. Ask your doctor which one you can use.
• - Try to use underwear made of pure cotton. This tissue allows a better circulation of air through the body.
• - Control your skin periodically. Look for red, dry, or painful areas that may become infected.
• - Consult your doctor if you find something of the mentioned.

Keep your feet dry and eliminate the possibility of injury.

On the care of the feet

The high levels of sugar also generate two complications that damage the feet:

•     Damage and affections in the nerves of the legs and feet. The phenomenon is also known as diabetic neuropathy . Its greatest damage is the loss of sensitivity in these areas.
•     Insufficient blood circulation in feet and legs. This is recognized as a peripheral vascular disease. It prevents the adequate and rapid healing of infections and wounds. It can be aggravated if you are a smoker.

Look for reddened areas that may become infected.

Tips to preserve the health of the feet

•     Always wear shoes that fit you well. Try not to have sharp edges. Avoid blisters, cuts, calluses, and anything that can get infected.
•     Carefully check your feet for any injuries. Attend to it in time.
•     Wash your feet daily with water at medium temperature. Then dry well between the fingers.
•     Apply moisturizing cream on your feet.
•     Cut the nails weekly.
•     Wear socks, stockings and slippers. That protects against the blows, but prevents them from getting too tight.

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Diabetic foot care

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.



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Both alterations have special repercussions on the feet, increasing the frequency of production of erosions, punctures, cuts, burns ... that if not taken care of become 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 an 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 it is advisable to perform it with good natural lighting and inspecting all the areas of the floor and the interdigital spaces with the help of a mirror. You should go to the doctor in case of lesions, changes in color, pain or swelling in 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). It is 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 feet dry by using non-medicinal talcum powder before putting on shoes every 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.
•     Do not cut or remove the hardness and calluses of your fingers, or use callicides, if necessary you should consult a podiatrist.
•     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. The wounds should be washed with soap and water, following the doctor's recommendations.
•     Feet should not be placed near fire, stoves or sources of heat.
•     You should avoid the use of rubber bands, rubber bands or socks with elastics on the edge, since they hinder blood circulation.
•     Avoid walking barefoot.
•     Use sunscreen also on your feet if you are exposed to the sun.

How to choose the footwear?
In conjunction with hygiene standards, good habits of selection and use of footwear must be maintained:

•     Footwear should always be used with socks.
•     Do not use sandals, flip flops or shoes that leave your feet uncovered.
•     The use of shoes with heels and ending in pointed shoes should be avoided.
•     The footwear must be comfortable, that does not adjust or cause chafing or injury to the feet.
•     The shoes are recommended to be leather, without internal seams, flexible, lightweight, breathable and with the floor that does not slip.
•     It is advisable 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.
•     New shoes should be used for short periods during the first days.
•     The purchase of orthopedic shoes must be made under criteria and medical prescription.
•     The shoes must be properly maintained, repaired and ensuring the good condition of the soles.
•     You should check the inside of the shoe before putting it on, to avoid any element (stone, gravel, any part of the shoe ...) that could injure the foot.
•     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 areas of the foot.
•     The socks and stockings must be made of natural fabrics (linen, cotton, wool) 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.
•     The socks or socks should be changed daily, and if the feet sweat a lot or much exercise has been done more than once a day.

Very important!

•     All diabetic patients must be properly vaccinated against tetanus.
•     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.

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CARE OF THE FEET IN THE DIABETIC PATIENT

Foot care is essential in people with diabetes. The problems of circulation, the lower sensitivity and the greater tendency to infections that this disease produces make it appear more easily wounds on the feet and also that they evolve worse.



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To prevent foot problems, it is essential to control the blood sugar level (with diet, medication and regular exercise) to avoid those circumstances that worsen the circulation (snuff, lack of exercise, etc.) and to take proper care of his feet. On the other hand, the control and early treatment of the injuries that may appear is the key to prevent them from progressing quickly, leading to serious injuries and serious and definitive sequelae.


HIXIENE

WASHED. You must wash your feet daily. For this we recommend:

• - Use warm water (32-35 ºC). Check the water temperature with a bath thermometer or with the elbow. The patient may have neuropathy and his sensitivity decreased and he may not notice the temperature. If the water is too hot it can even burn without noticing it.
• - Use neutral soap.
• - Do not leave your feet in water for more than 5 minutes, to prevent the skin from macerating. Use a soft bath mitt.
• - Avoid the use of harsh brushes or mittens or horsehair that may injure the skin.
• - You should wash the entire foot with special attention between your fingers.

Foot wash

DRYING Dry the feet well, with a soft towel and insisting between the fingers.

HYDRATION. If the skin is dry, apply a thin layer of cream or moisturizing lotion on the plants and on the dry areas, but never between the toes. Wet and macerated skin facilitates the growth of fungi and the appearance of infections.

NAIL CARE: Too long, too short or badly cut nails can cause problems and cause injuries and infections.

• - Cut the nails using scissors with blunt tips to avoid cuts.
• - The best time is after washing the feet, when they are softer.
• - Cut the straight nails: leaving the edges straight and without cutting the corners and soften the tips with a cardboard file. Do not cut too much: let it protrude 1 mm in front of the finger pad.
• - If you have vision or skill problems, ask a family member for help or go to a podiatrist, especially if your nails are thick and hard.

DAILY EXAM
After washing, you should examine your feet daily . The best way is sitting and in good light. If you have difficulties, you can help yourself with an unbreakable mirror or ask a relative to examine your feet, especially if you have vision problems. You should pay attention to: lesions between the fingers, hardness on the sole of the foot, calluses, cracks, blisters, discoloration, wounds or ulcers, etc.
   
foot

FOOTWEAR

• - You must always wear footwear and socks or stockings. Never walk barefoot, not even inside your house.
• footwear
• - The suitable footwear will be made of breathable material (leather or canvas), light and flexible, with non-slip sole and not too thick, it should not have internal seams and the heel will be of a discreet height (less than 5 cm). Do not use plastic shoes or materials that prevent the foot from "breathing". It is also not advisable to use sandals because they leave the fingers and the heel unprotected.
• - When buying shoes, make sure they are comfortable from the start, not too loose or tight and never buy them waiting to stretch them.
• - When you release shoes, start using them little by little; a few days before, put them at home for half an hour, gradually increasing the time.
• - The stockings and socks should be soft, preferably cotton, yarn or wool, without seams or folds. Do not use rubber bands or tight elastics, because they hinder circulation.
• - Air and keep your shoes dry and change socks or stockings daily.

WHAT YOU CAN NOT DO:

• - Do not put your feet near fire, stoves or radiators, or use hot water bottles or electric blankets to heat them.
• - Do not apply home remedies or callicidal ointments, or use sharp objects such as razor blades to remove hardness or calluses, call a professional.
• - Do not use tight shoes, or sashes, or rubber bands or elastic bands that hinder circulation.

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Foot care: American Diabetes

The care of the feet

Check your feet every day and go to your treating doctor as soon as possible, if you notice a foot injury. Make sure your treating doctor checks your feet, at least once a year or more frequently in case you have foot problems. The health professional should also provide you with information about foot care, as well as explain what to do and what to avoid. Most people can avoid all serious problems in their feet by taking a series of simple steps. So let's start taking care of your feet today.



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Prevention

The healthcare professional who treats you should perform a complete examination of your feet at least once a year, and more often, if you have foot problems.

Remember to take off your socks and shoes while waiting for the medical examination.

Call or check with your doctor, if you have a cut or crack in the skin, or if you have an ingrown toenail. Also, check with the healthcare professional who treats you if your feet change color, shape, or simply if you feel any sensation.

different (for example, they become less sensitive or hurt).

If you have calluses or calluses, the health professional can cut them off. You can also cut your toenails, if you are not in a position to do so.

Because people with diabetes are more likely to have foot problems, you can include a foot care specialist within the team of health professionals who care for you.
How to take care of your feet

There are many activities you can do to keep your feet healthy.

•     Take care of your diabetes. Work with the health team that treats you to maintain your blood glucose level within normal parameters.
•     Check your feet every day. Observe bare feet and look for red spots, cuts, swelling and blisters. If the soles of your feet can not be seen, use a mirror or ask someone to help you.
•     Stay more active Plan your physical activity program with the team of health professionals that assist you.
•     Ask your doctor about Medicare coverage for special shoes.
•     Wash your feet every day. Dry your feet carefully, particularly between your toes.
•     Keep the skin soft and smooth . Apply, by means of a massage, a thin layer of skin lotion on the instep and sole of the feet, but do not apply lotion between the toes.
•     If you can see and touch your toenails, cut them whenever necessary. Cut the toenails in a straight line, straight, and file the edges with an emery file or a nail file.
•     Wear shoes and socks at all times. Never walk barefoot. Wear comfortable shoes that protect your feet and have good fit. Check the inside of the shoe before putting it on. Make sure the liner is soft and that there is no object inside.
•     Protect your feet from heat and cold. Wear shoes on the beach or on the hot pavement. Do not immerse your feet in hot water. Test the water before submerging the feet, as you would before bathing a baby. Never use hot water bottles, pads or electric blankets. Possibly, burn your feet without realizing it.
•     Keep blood circulating towards the feet. Put your feet up when you are sitting. Move the toes, and move the ankles up and down for 5 minutes, two (2) or three (3) times per day. Do not cross your legs for extended periods of time. Do not smoke.
•     Start now. Start today with good care of your feet. Set a schedule to check your feet every day.

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7 basic to take care of your feet if you have diabetes

For all people living with diabetes it is very important to take care of their feet . This is because there can be two chronic complications that endanger the health of this area of ​​the body.



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    According to the Spanish Diabetes Society , blood glucose levels can cause peripheral arterial disease or hardening of the arteries . This causes the muscles of the legs to work hard because they do not receive enough blood and oxygen.

The second chronic complication is neuropathy or damage to the nerves that cause numbness in the feet . It can also decrease the sensitivity, loss of muscle reflexes, deformation of the fingers and feet. All this favors the appearance of sores, calluses, ulcers, blisters or other wounds that do not heal.

That an oversight does not stop your steps

If you live with diabetes mellitus it is very important that you take care of your feet every day. This reduces the risk of losing your foot , a finger or even your leg. These are seven basic recommendations of the National Diabetes Education Program of the United States .


1. Daily review. Every night check the feet when you take off your shoes because there may be problems without feeling pain. Verify that there are no sores , red spots, swelling or infection in the nails. If you have a hard time bending over to see them, use a mirror or ask a family member for help.

2. Wash them every day. Make sure you do it with warm water, not with hot water. Do not soak the feet to prevent the skin from drying out . It is suggested to use talc or cornstarch between the feet to keep the foot dry and prevent infection .

3. Hydrate them. To avoid cracking it is important to use some lotion, cream or Vaseline on the top and bottom of the feet, never put them between your fingers, this could cause an infection.

4. File the calluses carefully. If you notice that you have calluses it is advisable that you go with a podiatrist to explain the best way to take care of them. One option is that after the bath you use a pumice stone to soften them, do it carefully, in only one way so as not to hurt the skin. Do not cut, or use razor blades, patches, or liquids to remove them, so you avoid infection.

5. Nail cuts. Cut your toenails with a nail clipper after washing and dry your feet. Do it in a straight line and file the edges with a nail file, not the cuts. If you notice that the nails are thick or yellowish, they bend and grow inside the skin, then go with a podiatrist for the ideal treatment.

6. Always wear socks and shoes. Never walk barefoot, or inside your house, you could step on something and hurt your feet. Use socks or nylon stockings, clean, preferably without seams and lightly padded, always with shoes to prevent the appearance of blisters and sores.

7. Keep the circulation active. When sitting, try to raise your feet and move your fingers for 5 minutes, two or three times a day. It also rotates the ankles in and out to improve the flow of blood to the feet and legs. Avoid keeping your legs crossed for a long time.

Remember that the ideal is to keep the level of your blood sugar under control , which helps keep your feet healthy . Beware!

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How to take care of your feet if you are diabetic?

Although you must take care of your feet in any circumstance, in case of suffering from diabetes it is more important, since the zone can present complications if it is not treated properly.



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Neuropathy, circulation problems and infections can lead to the development of problems in your feet if you have diabetes. The good news is that you can put in practice some precautions to take care of your feet.

Good management of your diabetes and a healthy lifestyle help keep the disease under control with some ease. You can prevent some complications if you follow this regimen to take care of your feet.


How should you take care of your feet daily?

You can start by adopting some habits to take care of your feet and try to do them every day. If for some reason it is very difficult for you to inspect your feet, you can ask someone for help or use a mirror:

• Avoid sitting cross-legged or standing for long periods of time.
• Observe both your feet and your fingers: on the top, sides, heel, sole and also between the fingers. Notify your doctor if you discover sores, redness, cuts, blisters or bruises.
• Wash your feet daily with warm water and mild soap. Check the temperature of the water with your fingers or elbows before inserting your feet. Due to diabetes it can be difficult to detect the temperature with these.
• Dry your feet well. Infections can develop easily in wet areas.
• If you feel rough or dry feet use a lotion or oil to moisturize them but avoid the interdigital area.

Healthy habits to take care of your feet
If you stick to these good habits to take care of your feet, you will be taking a good step to keep them healthy:

• Antiseptic solutions can burn the skin of the feet. You must use them under the supervision of your doctor.
• Do not use hot pads, hot water bottles, or electric blankets on your feet.
• Avoid walking barefoot on the pavement or sand.
• Protect your feet from the heat and extreme cold.
• Do not try to remove calluses, blisters, warts or other foot injuries by yourself. Avoid using chemical wart removers, razor blades, plasters or liquid callus removers.

The care of your nails

It is important that people with diabetes take proper care of their nails.

Visual difficulty, nerve problems and changes in circulation in the legs or feet due to poor positioning can pose a risk to your health.

Check with your podiatrist if you want to perform good foot care consistently.

This way you will have a more exact guide of how to do it, since you will have to know what is the correct way to avoid an ulcer or pain in the foot.

Here are some tips that can help you:

• Trim the toenails after the shower, this way they will be softer.
• Make straight cuts, in this way you can prevent ingrown toenails. Do not cut the corners and use a file to soften the edges of them.
• Avoid cutting too short the nails.
• Go to a specialist to cut your nails if you notice that you have difficulty doing so, if your nails are thick or if they have a yellowish hue.
• Your shoes and socks
• If you have any type of neuropathy or nerve damage that affects the sensation of your foot, you may miss cuts or bumps.

It is essential that you protect your foot using footwear at all times.

Shoes
Use comfortable shoes, with good space, especially in the area of ​​the fingers.
Avoid using plastic shoes or materials that do not have ventilation. Opt for materials such as leather, canvas or suede.
Avoid wearing strappy sandals, flip flops, open-toed shoes and high heels.
Choose preferably footwear that can be adjusted with Velcro, buckles or laces.
Check the inside of your shoes for any holes or any element that may cause pressure or irritation in the foot.
Give rest to your feet or change the shoes after a period of 5 hours to vary the pressure points.

SocksThe so forgotten socks
They provide a layer of protection between the feet and the shoe.
Use clean, dry socks, and avoid those that have sharp seams or are very tight on the leg.
Sleep with socks when your feet are cold.
Signs of foot problems
You must recognize these early warning signs. Pay special attention to the following:

• Burning, tingling or pain in the feet.
• Insensitivity to cold, heat or touch.
• Changes in color or shape of the foot.
• Loss of hair on the feet, legs or calves.
• Thickening or yellowing of the nails.
• Blisters, sores, ulcers, infected pimples or ingrown toenails.
• Visit this article: 6 natural remedies for swollen ankles and feet

Are there complications?
Over time, blood sugar levels can cause nerve damage and circulation problems that end up damaging your feet.

If you pass the complications by high, it is possible that they derive in infections that, of not healing, cause the death of the tissue (gangrene).

Treatment for this may include surgery to remove dead skin, either a finger or even part of the leg.

Remember that foot problems related to diabetes get worse quickly. Seek immediate medical attention.