Diabetes

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Facts on Diabetes and Your Feet

Facts:

• Proper foot care can significantly reduce the risk of limb loss in diabetic patients.
• Poorly controlled blood sugars increase the risk for lower extremity infections and amputations.
• Diabetic Lower Extremity infections may be complicated and require hospitalization.
• Diabetics are at risk for circulatory problems and diminished feeling in the feet.
• Smoking has a detrimental affect on circulation.

Problem Prevention:

The key to avoiding diabetic foot problems is to keep blood sugar levels under control. In addition, performing a daily foot inspection is necessary. A hand held mirror is helpful for individuals to view the bottom of their feet. Diabetics unable to perform his or her own exam should have a family member or friend assist in the inspection. The American Diabetes Association also recommends an annual screening exam with a foot care specialist for diabetes. If the individual suffers from reduced blood supply or diminished sensation then more frequent exams by the specialist are recommended.

Problem Prevention Tips:

Daily foot inspections and what to watch for:

• Changes in Skin Color: Redness is often a sign of infection. A purple hue is often associated with venous disease. Blackened skin may indicate tissue death.
• Drainage, Bleeding or Odor: Yellow or thick discharge, odor or bleeding may be a sign of infected or dead tissue.
• Swelling: A swollen foot may be a sign of infection or a change in blood flow.
• Temperature Changes: Warm spots may mean the feet are infected. Cold feet may be associated with poor blood flow.
• Changes in Feeling: Numbness, burning, tingling, or lack of feeling may mean nerves are damaged.
• Ingrown Toenails: Nails that are growing into the skin may be a sign the nails have been cut too short or that one's shoes may be too tight.

Washing procedures and other special care:

• Wash your feet daily in warm (not hot) water. Use a mild soap. Dry well. Be sure to wash and dry between your toes, too. Don't soak your feet unless instructed by a foot specialist.
• Use a lanolin-based lotion or cream each day. This helps prevent dryness and scaling. Don't put lotion or cream between your toes.
• Never use a heating pad or hot water bottle for any reason.
• Don't use medications on your feet unless instructed by a foot specialist and follow those instructions carefully.
• Don't put your shoes on without first checking inside them for pebbles, rough seams, or other potential irritants.
• If you have circulation problems, avoid crossing your legs when sitting.
• Avoid wearing girdles, garters, or any garment which may inhibit blood flow to your feet.
• Never cut your corns or callous yourself, you may invite infection.
• Avoid weight gain, or lose weight if necessary, to minimize the pressure on your feet.
• Never go barefoot; a minor cut or scratch that goes unnoticed could lead to a serious infection.
• Be very careful to wear smooth fitting socks and stockings (no mended or seams).

Shoe Protection:

It is important for the diabetic to take extra time to buy the correct type and well fitting shoes. Some shoe buying tips are as follows:

• Leather provides stability and "breathes" helping to keep the feet dry.
• Buy shoes that fit in the store, don't expect tight shoes to stretch.
• The upper part of the shoe should be soft and flexible; the lining should be smooth and free of seams.
• The toe box should allow all toes to wiggle freely without rubbing against the front or top of the shoe and with about 3/4 inch space between the big toe and the front of the shoe.
• Instep should cushion arch comfortably, without causing irritation.
• Heels should fit snugly, with no pressure, no pinching nor slipping.
• The sole should only flex at the ball of the foot.
• Buy shoes in the mid-late day allowing for mild stretching and swelling of the foot.

Yearly Pressure Analysis of Feet:

Diabetic patients often have impaired circulation and limited sensation in feet. Thus, areas of abnormal pressure can go unnoticed creating wounds and complications on the bottom or top of the foot. These abnormal pressure points often start as a Corn or Callous and then progress to an ulcer or open wound. Foot wounds are often slow to heal because of the impaired circulation and abnormal pressures and if ignored, these wounds may lead to an amputation. Diabetic foot wounds account for 50% of all non-traumatic amputations of the lower extremity.

It is imperative all diabetic patients seek a Computerized Gait Scan and pressure analysis to assess biomechanical foot function. The gait and pressure analysis report generated by this test identifies those patients at risk for ulcers and allows for preventative measures to be implemented.

One key preventative measure is the use of foot Orthotics. Orthotics are customized insoles worn in the shoes. They help reduce peak pressure areas by distributing weight evenly, thereby alleviating high pressure points on the foot where an ulcer may develop.

The best way to test biomechanics and make Orthotics is from the data gathered while you are walking. After all there is no problem with weight distribution when you are sitting or lying down. Here is how the Gait Scan works. You simply walk across a computerized mat which scans your feet in motion, taking precise measurements of the way your feet touch the ground and how you distribute your body weight. The computer creating a complete and accurate analysis of your feet summarizes that information. The foot care specialist then evaluates the computer image and correlates it with the physical exam. The Orthotics are then designed based upon the diabetic's foot care needs as determined by the foot specialist and prepared for the patient.

Summary:

The importance of proper foot care for diabetics cannot be stressed enough. Check your feet and toes regularly for cuts, sores, bruises, bumps, blisters, color changes and infection. Daily washing with warm water, never hot water, and good skin care are important. Use moisturizing lotion or cream regularly and wear thick, soft socks to protect your feet. Remember, the average person takes 8,000-10,000 steps per day, a Gait Scan and pressure analysis test will be your first step toward good health.

Pittsburgh Family Foot Care, P.C.
Main Location
2001 Waterdam Plaza Drive
Suite 207
McMurray, PA 15317
Tel: 724.941.9440
Fax: 724.941.9783
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