Diabetes and Foot Care

Diabetes

Diabetes is a serious disease that can develop from a lack of insulin production in the body or  due to the inability of the body's insulin to perform its normal functions. Insulin is a substance  produced by the pancreas gland that helps process the food we eat and turn it into energy. If  incidence and mortality rates continue trending upwards, it is estimated that the number of  Canadians living with diabetes will reach 3.7 million by 2018/19.

Diabetic Neuropathy

Diabetic Neuropathy can cause insensitivity or a loss of ability to feel pain, heat, and cold. People with diabetes suffering from neuropathy can develop minor cuts, scrapes, blisters, or pressure sores that they may not be aware of due to the insensitivity. If these minor injuries are left untreated, complications may result and lead to ulceration and possibly even amputation. Neuropathy can also cause deformities such as Bunions, Hammer Toes, and Charcot Feet. People with diabetes need to take the necessary precautions to prevent all foot-related injuries. Due to the consequences of neuropathy, daily observation of the feet is critical. When diabetic patients take the necessary preventative foot care measures, they reduce the risks of severe foot conditions.

Poor Circulation

Diabetes often leads to peripheral vascular disease that inhibits a person's blood circulation. This condition is when the arteries narrow, leading to significantly decreased circulation in the lower part of the legs and the feet. Poor circulation contributes to diabetic foot problems by reducing the amount of oxygen and nutrition supplied to the skin and other tissue, causing  injuries to heal poorly. Poor circulation can also lead to swelling and dryness of the foot. Preventing foot complications is more critical for the diabetic patient because poor circulation  impairs the healing process and can lead to ulcers, infection, and other severe foot conditions.

Treatment and Prevention

Footwear and orthotics play an important role in diabetic foot care. By customizing to the foot, orthotics provides the comfort and protection needed in diabetic foot care. Footwear constructed with Plastazote is also recommended frequently for the diabetic patient. Diabetic footwear should also provide the following protective benefits:  

  • High, wide toe box (high and wide space in the toe area).  
  • Removable insoles for fitting flexibility and the option to insert orthotics if necessary.
  • Rocker Soles are designed to reduce pressure in the foot's areas most susceptible to  pain, most notably the ball-of-the-foot.  
  • Firm heel counters for support and stability.  
  • If you have diabetes, you should be particularly alert to any problems you may be having with your feet. People with diabetes with neuropathy need to take necessary precautions to prevent injury and keep their feet healthy. If you have diabetes and are experiencing a  foot problem, immediately consult your foot care provider.

Footcare & Diabetes

Proper foot care is especially critical for people with diabetes because they are prone to  foot problems such as:  

  • Loss of feeling in their feet  
  • Changes in the shape of their feet  
  • Foot ulcers or sores that do not heal  

Simple daily foot care can prevent serious problems.  

The following simple everyday steps will help prevent severe complications from foot care:

1. Take Care of Your Diabetes
Make healthy lifestyle choices to keep your blood sugar within range. Work with your health care team to create a diabetes plan that fits your lifestyle characteristics.
 
2. Check Your Feet Every Day

You may have foot problems that you may not be aware of. Check your feet for cuts,  sores, red spots, swelling, or infected toenails. Checking your feet should become part of  your daily routine. If you have trouble bending over to see your feet, use a mirror to help. You can also ask a family member to help you. Important Reminder: Be sure to call your doctor immediately if a cut, sore, blister, or bruise on your foot does not heal after one day.

3. Wash Your Feet Every Day
Wash your feet in warm, NOT HOT, water. Do not soak your feet because your skin will  get dry. Before bathing or showering, test the water to make sure it is not too hot. It  would be best if you used a thermometer or your elbow. Dry your feet well. Be sure to dry between your toes.

 
4. Keep the Skin Soft and Smooth
Rub a thin coat of skin lotion or cream with the ingredient UREA in it, which draws in  moisture to help keep your feet free from cracks. Do not put lotion between your toes; this might cause moisture to stay between your toes, causing skin breakdown, leading to an infection.
 
5. Wear shoes and socks at all times.
Do not walk barefoot, not even indoors. It is common to step on something and hurt your feet. Always wear socks, stockings, or nylons with your shoes to help avoid the possibility of blisters and sores developing. Be sure to choose socks made of materials  that wick moisture away from your feet and absorb shock and shear, socks made of  these materials help keep your feet dry. Always check the insides of your shoes before putting them on. Ensure the lining is smooth and there are no foreign objects in the  shoe, such as pebbles. Wear shoes that fit well and protect your feet.

 
6. Protect Your Feet From Hot and Cold
Always wear shoes at the beach or on hot pavement. Put sunscreen on the tops of your feet for protection from the sun. Keep your feet away from radiators or open fires. DO NOT use a hot water bottle or heating pads on your feet. If your feet are cold, wear socks at night. Lined boots are good to keep your feet warm in the winter. Choose padded socks to protect your feet and make walking more comfortable. In cold weather, check your feet often to keep your feet warm to avoid frostbite.
 
7. Keep the Blood Flowing to Your Feet

Put your feet up when you are sitting. Wiggle your toes for 5 minutes, 2 or 3 times a day. Move your ankles up and down and in and out to improve blood flow in your feet and  legs.  

DO NOT cross your legs for long periods.  

DO NOT wear tight socks, elastic or rubber bands, or garters around your legs unless  advised by your doctor.  

DO NOT smoke. Smoking reduces blood flow to your feet. If you have high blood  pressure or high cholesterol, work with your health care team to lower it.

 
8. Be More Active

Ask your doctor to plan an exercise program that is right for you. Walking, dancing,  swimming, and bicycling are good forms of exercise that are easy on the feet. Avoid all  activities that are hard on the feet, such as running and jumping. Always include a short warm-up or cool-down period. Wear protective walking or athletic shoes that fit well and  offer adequate support.

    Foot Ulcers & Amputations

    Persons with diabetes are 20 times more likely to be hospitalized for non-traumatic amputation foot ulcers, and amputations are a significant cause of morbidity, disability, and emotional and physical costs for people with diabetes and poor circulation. Early recognition and treatment for risk factors such as dystrophic, overgrown toenails, calluses, fissures and corns can prevent or delay the onset of adverse outcomes.