Foot Care for People with Diabetes
Alternate Names : Diabetic Foot Care
Foot problems can be directly caused by diabetes. They can also be secondary
to some of the effects of diabetes on the feet. These effects most commonly
include loss of circulation and loss of feeling. A person with diabetes should
follow guidelines for good foot care to prevent unnecessary complications.
What is the information for this topic?
A person with diabetes often has
peripheral
vascular disease, or decreased circulation to the legs and feet.
Any
damage to the feet may heal slowly because of the poor circulation. The person
may also have diabetic
neuropathy, in
which nerve damage from diabetes causes decreased sensation in the legs and
feet. The person can develop an open area from pressure or from a cut, and not
even feel the sore. Untreated, the damaged area can develop a diabetic foot ulcer.
The following factors increase a person's chance of developing a foot ulcer:
diabetic neuropathy,
with damage
to the nerves supplying the feet
peripheral vascular
disease, with
decreased blood flow to the feet
a history of 10 years or more of
diabetes
male gender
blood sugar levels
that are not
under control
diabetic retinopathy, or
damage to
the retina of the eye caused by diabetes
cardiovascular problems caused by
diabetes
kidney problems caused by
diabetes, including chronic renal
failure
a history of skin ulcers or
amputation of a limb
conditions caused by increased pressure on the feet, such as corns and
calluses
foot bones that are deformed or have limited movement, such as bunions
thick toenails
Guidelines for preventing foot ulcers from diabetes
Inspect the feet daily for blisters, cuts, scratches, scalings,
discolorations, and unusual swelling of the feet or toes. Pay particular
attention to the area between the toes. If vision is poor or if reaching the feet is
difficult, a member of the family should assist.
Clean and soak both feet in tepid water for 15 minutes before trimming
toenails.
Trim toenails so they are even with the end of the toe, and file sharp edges smooth.
Corners should never be cut or dug out.
See a healthcare professional if the nails grow into the flesh or if they are
difficult to cut.
Wash feet daily with warm water and mild soap. Dry feet completely,
especially between the toes.
Gently massage a bland lubricating cream into the feet after drying them,
especially around the toenails and heels. Do not put creams or ointments
between the toes. Dust a non-medicated powder between the toes.
Never use strong antiseptics, especially tincture of iodine, disinfectants, or
bleaching agents, on the feet.
If a cut is present, wash the area with an antibacterial soap. After drying
the area, apply an antibiotic ointment and cover it with a sterile
dressing.
Avoid extremes of temperature. Protect feet from sunburn and
frostbite.
Wear clean cotton or wool socks to bed if feet are cold. Hot water bottles
or heating pads should not be used.
Change socks and stockings daily. Circular garters or stockings with
elastic at the top should not be worn. They may cause a tourniquet effect that
will lead to swelling of the lower leg.
Wear properly fitted shoes with soft uppers and flexible soles, preferably
with adjustable straps or laces. Avoid walking barefoot or wearing
open-toed or open-heeled shoes.
Break new shoes in gradually, by wearing them for a short time each day.
Check inside shoes daily for foreign objects, nail points,
and torn linings. If the linings are torn or crumpled, the shoe should be
discarded.
Corns or calluses should be treated by a healthcare professional. Never cut
them with a razor blade or use chemicals to remove them.
Monitoring by the healthcare professional
On each visit, the healthcare professional should specifically ask about
any foot problems or leg or foot pain when the person is sitting, standing, or
walking.
The healthcare professional should check the pulse in the groin, behind the
knees, behind the anklebones, and on top of the feet. He or she should listen
with a stethoscope to the blood vessels in the legs.
The healthcare professional should test the person's ability to feel sharp
and dull sensations, vibrations, and light touches to the feet and toes.
The healthcare professional should look for corns, calluses, deformities,
cuts, bruises, bunions,
diabetic foot ulcers, and
infections.
Approximately 50% to 70% of foot
amputations among people with
diabetes could be prevented if foot problems are identified early and
properly treated.
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