Peripheral Arterial Disease

Foot Care Alert: Special Care for Diabetics & Other High Risk Patients

Foot care is important for everyone; but for the person with diabetes, it is essential. This disease affects the circulation and the nervous system. It slows the natural healing process, and increases the risk of infection, so that minor injuries may quickly become serious.

The feet are often the first part of the body to be affected by this disease, but serious problems can be prevented by paying careful attention to your feet on a daily basis.

"An ounce of prevention is worth a pound of cure" was never so true as for feet affected by diabetes. Poor care can lead to serious problems, and even amputation.

Why is Special Care Required?

Foot problems are common in people with diabetes. This is why you need to check your feet for cuts, abrasions, and signs of irritation every day and to protect them with proper footwear. When you do not protect your feet properly, infections can develop from minor injuries.

Here are a few reasons why this happens:

Diabetes can damage nerves in the feet, making them less sensitive to pain. This means that you may not feel a minor cut or abrasion until severe infection develops.
Diabetes can cause reduced circulation. This is a problem since proper blood flow is necessary for healing injuries.
Elevated blood glucose can interfere with the body's ability to fight infection from cuts and abrasions. It also hampers the healing process.
You can reduce your risk of infection by keeping your blood glucose under control. Also, learn now how to properly care for your feet. It will pay off as you get older.

How to Care for Your Feet

Your chiropodist will teach you how diabetes affects your feet, and will set up a foot care program for you. be seen on a regular basis for evaluation and foot care. To properly care for your feet, you should do the following each day:

Washing:

• Wash your feet with mild soap and lukewarm water. Always check the water temperature with your elbow or another part of your body where sensation is good before putting your feet in. Never put your feet into hot water.
• Never soak your feet. This dries the skin and makes it more prone to cracking and infection.
• Use a soft washcloth to clean your feet thoroughly and to get all the soap off.
• Use a soft towel to dry your feet, especially between your toes. Never dry or warm your feet by putting them on or near a radiator or heater.

Examining:

• Inspect your heels and the tops and bottoms of your feet for skin irritation or breakdown. Look for sores, cuts, blisters, cracks between the toes, and blue, purple, or white spots.
• Be sure your feet feel warm and that there are not any red "hot" spots or swelling. Check for irritation or scaling between the toes, too. If you cannot see the bottoms of your feet, use a mirror.
• If you are unable to examine your feet yourself, have someone do it for you. Notify your chiropodist right away if anything looks unusual.

Skin Care:

• Apply a water-soluble moisturizing cream such as Eucerin®, Vaseline Intensive Care® or Nivea® to keep skin soft. This is especially important for dry and callused skin. Never use cream between your toes or on open sores. Do not use, mineral oil, or perfumed lotions that contain alcohol.

Corns and Calluses:

• Gently and gradually rub down corns, calluses, and other hard skin with a dry washcloth, pumice stone, or emery board. This is most effective after a bath or shower.
• See your chiropodist if you cannot see your feet adequately, if you have reduced sensation, or if you have poor circulation. Have your chiropodist remove corns or calluses if they are a problem; never do it yourself.
• Do not cut corns or calluses. Also avoid over-the-counter corn and callus removers or remedies. These contain acid and will burn the skin.

Toenails

• Cut your toenails after a bath when they are softest.
• To avoid cutting skin around the toe, trim toenails straight across using nail clippers, or file with an emery board. Do not use scissors.
• Carefully file sharp toenail edges to prevent them from cutting into adjacent skin.
• If it is difficult to trim your own nails, or if you have reduced sensation or poor circulation, schedule an appointment with your chiropodist.

Footwear:

• Wearing of proper footwear is essential in the prevention and healing of foot ailments. Diabetics and high risk patients should schedule a footwear education appointment with their chiropodist. It is also advisable to bring along the footwear that you are presently wearing. Sometimes special insoles are made to go into your shoes to make you comfortable and prevent problems.

What should I do if I have an infection?

An infection may be present if you see any combination of these symptoms:

• Redness
• Swelling
• Open Sores
• Pus
• Red Streaks
• Warmth

You may not feel any pain in this area due to a loss of sensation. The first thing you should do is call your chiropodist or physician. If it is after office hours, call your doctor's emergency number.

For a minor infection, your chiropodist will clean the infection and may give you antibiotics to keep the infection from spreading and to help it heal. Be sure to take the antibiotics for the entire length of the treatment, since it will not work if you skip doses. You will need to dress your wound at least once a day.

Your chiropodist will want to see you for follow-up visits to be sure the infection is healing properly. Prompt detection of an infection in its earliest stages will help to avoid a possible hospital stay.

In addition to diabetics, the following conditions are also at risk for severe foot problems and should be seen regularly by a chiropodist:

• Arthritis
• Psoriasis
• Poor Circulation
• Visual Impairments
• Systemic Disorders
• Foot Infections
• Neuropathy