People with diabetes are prone to foot problems because uncontrolled diabetes can damage their blood vessels and nerves. This, in turn decreases the ability to sense injury or pressure on the foot. The immune system also gets altered due to diabetes and leads to decreased ability of the body to fight infection. Small infections can rapidly progress to death of the skin and other tissues, which may require amputation of the affected limb to save the patient’s life. Any foot injury may go unnoticed until severe infection develops.
A new study suggests that patients with diabetes who are at high risk for developing leg and foot ulcers can control these complications by monitoring their foot skin temperatures at home. In this study, effectiveness of at-home infrared temperature was monitored in 85 at-risk patients.
41 patients were assigned to a standard therapy and were given therapeutic footwear, diabetic foot education and regular foot evaluations by a podiatrist or a diabetologist. Remaining 44 patients were given enhanced therapy in which they received standard care plus a handheld infrared skin thermometer to measure temperatures on the sole of the affected foot in the morning and evening.
According to the study, if the skin temperature is found to be elevated more than 4 degrees F compared to the other foot, then the patient is considered at risk of developing foot ulcers. On the basis of this finding, they were instructed to minimize their physical activity and follow the treatment prescribed by the doctor.
The study continued for 6 months. During this time 9 cases of foot complications were seen in the 1st group who received standard therapy, 2 patients of the same group also developed infection and local foot amputation was performed. Whereas, in the other group who received enhanced therapy, no infection or amputation occurred and only 1 case of foot complication was reported. In the end of the study, the researchers realized that the results might have come from enhanced vigilance among patients who were given thermometers.
Apart from checking foot temperature, diabetics must not forget to take care of their foot on a daily basis.
Some tips for daily foot care:
- Inspect the top, sides, soles, heels and between the toes of your feet every day.
- Wash the feet everday with lukewarm water and mild soap, and dry them thoroughly especially, between the toes. Strong soaps may damage the skin.
- Check the temperature of the water before immersing the feet, as the normal ability to sense hot temperature is usually impaired in diabetics. Burns can easily occur.
- Gently and thoroughly dry the feet, particularly between the toes, because infections can develop in moist areas.
- Apply a thin coat of lubricating oil or lotion after bathing the feet. Because of skin changes associated with diabetes, the feet may become very dry and may crack, potentially causing an infection. Soften dry skin with lotion, petroleum jelly, lanolin or oil. Do not put lotion between your toes.
- Before trimming the toenails, soak the feet in lukewarm water to soften the nail. Cut the nail straight across, since curved nails are more likely to become ingrown.
- Exercise daily to promote good circulation. Avoid sitting with legs crossed or standing in one position for prolonged periods of time.
- Stop smoking. It decreases blood flow to the feet.
- Wear comfortable, well-fitting shoes and wear them all the times to protect the feet from injury.