Tuesday, November 20, 2012

Foot Health Issues Related to Diabetes Awareness Month

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By Terry Orr

As a Type-2 Diabetic – my healthcare professionals (primary care, foot, eye, and dentist) each are fully aware of my health-related issues and we pass along any new information regarding diabetes and any changes in my condition or medications.  One positive benefit from doing research on diabetes this month, finding new resource, web/blog-sites and some new information to share and use myself.

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Once again, we were able to find an excellent resource that you should bookmark and review when time permits.  The Institute for Preventive Foot Health (IPFH) has an exceptional wealth of excellent, current and easy to understand information regarding foot health.

Below are some important excerpts from IPFH.ORG website.

According to the American Diabetes Association…
  • Nearly 26 million children and adults in the United States have diabetes;
  • Another 79 million Americans have pre-diabetes and are at risk for developing type 2 diabetes;
  • The estimated total national cost of diagnosed diabetes in the United States is $174 billion.

IPFH strongly advocates that people with diabetes take extra care to help prevent damage to the feet that can result in ulceration and amputation.  Here’s why:
  • According to the National Institutes of Health, 60% to 70% of people with diabetes have some form of neuropathy (nerve problems / loss of sensation);
  • Neuropathy and other circulatory conditions (such as peripheral arterial disease or PAD) that affect the lower limbs put people with diabetes at high risk for ulceration and amputation;
  • According to IPFH's National Foot Health Assessment 2012, the incidence of diabetes in the U.S. adult population is 11%, but that incidence nearly doubles in people age 50 and over (19%);  
  • IPFH's National Foot Health Assessment also reported that fewer than half (46%) of people with diabetes have regular foot screenings with their doctor;  
  • IPFH's National Foot Health Assessment further reported that only 11% of people with diabetes said that they were properly measured and fitted each time they purchase new shoes (poorly fitted shoes contribute to the formation of sores and lesions on the feet that can lead to ulceration and amputation in people with diabetes).

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Daily Foot Care for People with Diabetes
If you have diabetes, you are at increased risk of foot problems and amputation. Therefore, it is very important that you check your feet—top, bottom, sides, between the toes, toenails—at least once a day.

The best time to inspect your feet is after a bath or shower. When your feet are dry (including between the toes), sit in a well-lit room. If you have trouble seeing the bottom or sides of your feet, use a mirror with an extended handle or any mirror that permits you to see your whole foot.

Look and feel for:
  • Bumps, lumps, blisters or bruises.
  • Cuts, sores, or cracked skin. Even the tiniest crack can become infected.
  • Patches of thin or shiny skin (which can signal lack of blood flow) or areas of redness (especially red streaks, which can signal the presence of infection).
  • Temperature differences (one part warm, another cold). This can signal lack of blood flow.
  • Pain, tingling, numbness or no feeling at all. These can signal nerve problems.
  • Ingrown toenails with red, puffy skin along the nail and tenderness or pain.
  • Loss of hair on foot or leg, which also can signal reduced blood flow.

If you have any of these signs or symptoms, seek medical care immediately. Your foot is at risk.
Pedicure Every Two Weeks
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Foot self-care:
  • In addition to doing daily foot inspections, see a foot care professional for regular foot examinations and preventive foot care.
  • If you have numbness, tingling or loss of feeling in your feet, be extra cautious. Make sure there are no sharp objects such as broken glass, nails, or exposed sharp edges on floors or in carpeting. Never walk or move around barefoot, even inside your house.
  • Wash feet daily using lukewarm, never hot, water. Use your elbow to test water temperature.  After washing, dry feet thoroughly and keep them supple by applying lotion only to the tops and bottoms of the feet. Don’t apply lotion between the toes, since this can create a moist environment that favors fungal growth.
  • Do not attempt to cut toenails if you have neuropathy or other foot problems related to diabetes.  See a podiatrist or a foot care nurse regularly for toenail care and foot examinations.  Never attempt to cut or file calluses or other protrusions on your feet.
  • Never use wart removers or other harsh chemicals on your feet.

On your feet:
  • IPFH suggests wearing only properly selected and fitted, as part of an integrated approach, padded socks with shoes with non-slip outsoles and any inserts or orthotics prescribed or recommended by a doctor or foot health professional.  Peer-reviewed, published studies have shown that wearing clinically tested padded socks can help prevent injuries to the skin/soft tissue of the foot, a major cause of diabetic ulcerations.
  • Padded Socks made from acrylic and acrylic blends have been demonstrated by clinical research to be best for the diabetic foot; 100% “natural” fibers (cotton, wool and silk) retain moisture and make feet vulnerable to irritation, lesions, athlete’s foot, blisters and other foot conditions.
  • Don’t wear the same pair of shoes every day (if possible, rotate between at least two pairs). Change your padded socks daily—more often if you are active.
  • Never depend on shoes to “fit better after they’re worn for a while.”  Trust the foot health professional who analyzes your gait and sizes your feet.  New footwear may “feel” large, but if all components are properly fitted as a system—padded socks, insert/orthotic, shoes—they will provide better protection.
  • Check inside shoes daily for sharp points, sharp edges, seams or other rough areas or foreign objects that may lead to cuts, wounds or abrasions on your feet.
  • Don’t cross your legs for extended periods, as this can reduce blood flow and create pressure points. For the same reason, don’t sit for more than an hour or two without changing positions.
  • Walk as much as possible; doing so enhances circulation to the feet and helps with weight and blood sugar control.

Buy shoes based on the way they feel, not by size:
  • You should be able to move your toes comfortably
  • There should be a space the width of your thumb nail between your longest toe and the end of the shoe.
  • The heel should fit comfortably, with minimal slippage.
  • The ball of your foot should fit comfortably into the widest part of the shoe without feeling pinched or tight.
  • You should not feel any rubbing or chafing. Remember that your feet tend to get larger from the exertion of daily activities, so make sure there is sufficient room for them to expand and still go through their full range of motion. If possible, shop for shoes near the end of the day, when your feet are larger.

Other significant websites to visit for current, excellent information and resources are the National Institute of Health (NIH) National Diabetes Education Program (NDEP) and the Centers for Disease Control and Prevention.
  • Feet Can Last a Lifetime – “A Health Care Provider’s Guide to Preventing Diabetes Foot Problems” is an excellent read and full of good information.
  • A Guide for People with Diabetes – Take Care of Your Feet for a Lifetime; and
  • ‘Preventive Foot Care in People with Diabetes’ by the American Diabetes Association.

That is a lot of information to absorb so please bookmark it and return another time to refresh your memory.  Also, if you are not taking care of your feet daily – now is a good time to start. 

Do you have any good information to share?  Please let us know – we are always looking for something new.  Thank you.

Happy Feet
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References and Links:

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