FOOT CARE IN DIABETES
In diabetes, three major factors could contribute towards foot problems:
- The blood of a diabetic usually has a higher than normal level of fats (hyperlipidemia) that tend to stick to arterial walls and clog it. This compromises blood flow to the foot.
- The nerves that control peripheral blood flow are a part of the artery wall. They also have arteries and capillaries of their own that get clogged and close partially. Hence the nerves degenerate and fail to respond to tissue oxygenation needs. As a result, the peripheral blood vessels do not open up to maintain blood flow to tissues as required. This happens all over the body and is called autonomic (involuntary nerve control) neuro-(nerve) pathy (damaged structure and function of that body part).
- The foot is very prone to infections. Any infection here is almost always due to multiple bacteria that are resistant to many common antibiotics. Therefore, even a trivial injury to the foot warrants proper medical care.
The combination of these three factors makes the foot the most vulnerable part of the body as far as compromised blood flow and recurrent and non-healing wounds are concerned. It is to be noted that diabetes is the commonest cause of non-traumatic foot amputations.
Importance of foot care in diabetes Infections (anywhere in the body) cause stress hormones to building up. This increases the blood sugar level further and helps the infection to spread even more. Since the foot is most vulnerable to infections (due to trauma while walking, playing or from ill fitting shoes), proper foot care alone can help to eliminate a lot of complications like the ones mentioned above.
Some tips you should follow for proper foot care
- Never cut the corners of your nails.
- File the nails straight across, never file them shorter than the underlying soft tissues of the toe.
- Never sit with the legs crossed as it may disturb the normal supply of blood to the feet.
- Do not apply heat in the form of hot water, hot water bottles or heating pads .
Wear comfortable shoes
- Tight fitting shoes not only cause direct trauma when walking, but also compress peripheral blood vessels, which further reduces blood supply. This can lead to infection and even gangrene (death of tissue) of toes or foot.
- Avoid wearing fancy shoes or high heeled shoes.
- Have not one but two comfortable shoes. All shoes press at different points. Two shoes would press at two sets of different places, hence changing shoes would also enable the foot to revive from constant pressure at any one point.
Always wear comfortable socks
- Wear comfortable socks that “breathe”, i.e. cotton or pure woolen ones.
- Wear soft socks with a padding to protect your feet at pressure points.
Keep a first aid kit handy
- Maintain a first aid kit that includes: antiseptic lotions and cotton, antibacterial cream, gauze pads, micropore or bandages, prepackaged cleansing towelettes.
Preparing to go to cold places
- Choose well- fitting comfortable and proper shoes that will protect your foot from cold and wet weather.
- Wear boots or shoes that will keep your feet dry
- Wear warm socks
- Find time to go indoors periodically and warm your foot to restore circulation
Preparing to go to warm / hot places
- Do not risk barefoot walking as it increases chances of foot trauma and also increases chances of contracting infection.
- When going to the beach, use shoes meant for walking there.
- Check the foot daily for presence of any blisters, cuts, scratches, sores, redness, increased warmth, ingrown toenails, corns and calluses.
- Wash both feet daily with mild soap and lukewarm water and gently dry it completely.
- Use lotion on your feet to prevent them from cracking. Do not apply lotion between your toes.
- Maintain correct toe nail length. If you have to cut/trim them, do so soon after bath when they are still soft.
- If you notice any abnormality, consult your doctor immediately.
I. Caring for a small cut or minor skin irritations
- Wash the area gently with mild soap and warm water (never use hot water), or antiseptic lotion (avoid using strong antiseptic lotions such as tincture of iodine), and apply antibacterial cream. Cover the cut with a gauze pad. Secure the gauze in place with micropore or bandage.
- Change the dressing daily.
II. Caring for blisters or minor burns
- Wash the area gently with a mild soap and warm water/ antiseptic lotion, apply antibacterial cream and cover with gauze. Secure the gauze in place with micropore or bandage.
- Change the dressing at least once a day.
- Use warm water to warm the skin (98 degrees Fahrenheit to 104 degrees Fahrenheit).
- Call for medical help immediately.
- Don’t rub the area or apply creams.
- Don’t try to walk on the affected foot.